0:01 hey y'all today we're going to talk
0:04 about why therapy sucks for men and that
0:05 may sound kind of confusing because here
0:08 I am a man here I am a psychiatrist
0:11 doing Psychotherapy with men so what on
0:12 Earth am I talking about why do I think
0:21 in my experience as a psychiatrist I do
0:23 actually believe that there are systemic
0:25 biases that make it hard for men to
0:27 engage in therapy and today we're going
0:29 to talk a little bit about what those
0:31 systemic factors are how we can
0:34 understand them and even how to overcome
0:36 some of those factors and move towards
0:38 more emotional health if you're ready to
0:39 take the next step on your mental health
0:42 Journey check out Dr K's guide it's an
0:44 immersive resource that distills over 20
0:47 years of my experience laid out in a way
0:50 that is tailored to your needs so if
0:51 you're ready to better understand your
0:53 mind and take control of it check out
0:55 the link in the description below so we
0:57 have to start by understanding where
1:00 this idea that talk therapy is the gold
1:02 standard for treating mental illness
1:05 comes from so what we really need to
1:07 understand is that the majority of
1:09 patients in the history of psychotherapy
1:11 have been women about 60 to 70 percent
1:14 of patients today who engage in
1:16 Psychotherapy are women the other thing
1:17 is that about 60 70 percent of
1:20 therapists today are actually women so I
1:22 think what happened early on in
1:24 Psychiatry or Psychotherapy is that the
1:26 majority of people we were helping were
1:28 women and so when me as a doctor when I
1:31 look at 10 of my patients and I see okay
1:33 so it looks like talking to people about
1:36 their feelings on average is the most
1:38 successful thing that I can do
1:40 but even though that's factually correct
1:42 I may not be taking into account that
1:44 seven out of those 10 people are women
1:46 and maybe the people who are getting
1:48 helped the most with talk therapy or
1:50 talking about their emotions are
1:52 actually women and it's not just me that
1:54 says this if you actually look at the
1:56 American Psychological association's
1:59 guidance for working with boys and men
2:02 they sort of point out a systemic bias
2:04 in the way that we diagnose men and
2:07 women and that's a lot of the diagnoses
2:08 that women get like depression and
2:10 anxiety which by the way women are about
2:12 two to three times as likely to be
2:14 diagnosed with that stuff a lot of those
2:17 diagnoses have to do with feelings and
2:19 being able to articulate stuff so for
2:21 example major depressive disorder
2:23 involves feeling sad when you're
2:26 depressed right makes sense and that a
2:28 lot of men are actually diagnosed with
2:30 what we call externalizing disorders
2:34 things like addictions or sociopathy or
2:36 antisocial personality disorder so these
2:38 are disorders that involve Behavior
2:40 behaviors so I think they're sort of
2:43 clueing us in on a really important idea
2:44 which is that when men feel something
2:48 they act on it as opposed to articulate
2:50 it or talk about it and if we tunnel
2:52 down into a little bit about how men
2:54 deal with their emotions we'll kind of
2:56 see that this is true in general as well
2:59 because if you're a man an emotion is a
3:02 problem to be solved not something to be
3:04 talked about right so think about like
3:07 if you get bullied on the playground and
3:09 you feel ashamed of yourself and people
3:12 call you a fat kid and beat you up that
3:14 isn't something you talk about in fact
3:17 if you go and cry to Mommy or cry to the
3:18 teacher you're actually treated worse
3:21 you're taught that articulating problems
3:24 and talking to people is cause for
3:26 punishment instead what you're supposed
3:28 to do if you're a man is fix the problem
3:31 right so if kids make fun of me for
3:32 being fat I'm supposed to lose weight
3:35 get ripped learn martial arts and the
3:37 next time they talk I'm going to teach
3:40 them who's boss it's if you sort of
3:42 think about it the solution to an
3:44 internal feeling feeling ashamed is to
3:46 take an action and change the
3:49 circumstances that make me feel that way
3:52 if I'm feeling ashamed because I don't
3:53 have a job and I don't have any money
3:56 what should I do about that should I go
3:58 cry to Mommy about how I don't have a
4:00 job or don't have money should I cry to
4:02 my girlfriend about how I'm broke all
4:04 the time no if you're a man you need a
4:06 man the [ __ ] up go out there get a job
4:09 and start making money if you're feeling
4:11 bad in here as a man what we're taught
4:13 is you're supposed to go fix the problem
4:16 out there and this also manifests in
4:19 men's reluctance to engage in couples
4:21 counseling so oftentimes if you're in a
4:22 relationship and I'm assuming a
4:24 heteronormative relationship for a
4:26 second and you know your wife or your
4:27 girlfriend says hey I think we need to
4:29 go see a counselor oftentimes men will
4:31 be reluctant to engage in that and if
4:33 you actually look at the research for
4:35 why men are reluctant what you discover
4:37 is it's not that they're trying to put
4:38 their head in the sand or their avoiding
4:40 a problem or anything like that they
4:43 actually feel outgunned in therapy they
4:45 feel like when they go to a couple's
4:47 counselor my partner is so much better
4:49 at understanding and articulating their
4:51 feelings that they can sort of make
4:54 their case better than I can and when
4:55 the therapist tries talking to me like I
4:57 just say I don't know a lot or I'm not
4:59 sure like I don't know how to someone's
5:01 asking me to play basketball but I don't
5:03 know how to dribble and so what men
5:05 actually feel like in couples counseling
5:06 is that they don't know how to
5:08 effectively communicate so imagine a
5:10 situation where you're like going into a
5:11 court of law and there's a judge there
5:13 and your wife makes her case right she
5:16 says hey all Oak is neglectful he
5:18 doesn't appreciate me I do so much for
5:20 him and I know he works hard but he's
5:22 really short with me sometimes and it
5:23 really hurts and I feel really
5:26 underappreciated and then as a man how
5:28 do I respond to this I don't speak the
5:46 and so as a dude you're like you don't
5:48 know how to communicate in the way that
5:51 therapists like so men literally feel
5:53 outgunned to engage in things like
5:55 couples therapy and that's because we as
5:57 men communicate our emotions in a
6:00 different way so my favorite example of
6:02 how men communicate differently is the
6:04 negative expression of a positive affection
6:05 affection
6:07 so when we like someone and we're proud
6:09 of one of our homies or our Bros we
6:11 don't say that to them right in fact
6:13 what we do is we kind of dog them about
6:15 it if my friend has been single for a
6:16 while after a bad breakup and starts
6:17 dating someone else and I feel really
6:19 proud and good about that I don't say
6:21 hey friend I'm really proud of you and
6:23 I'm proud that you've been able to find
6:26 someone who sees The Lovable qualities
6:29 within you that I see I'm proud that you
6:31 found someone who treats you the way
6:33 that I think you deserve to be treated
6:35 who loves you for who you are in the way
6:38 that I love you for who you are in the
6:40 history of humanity I do not think that
6:42 sequence of words has ever been spoken
6:44 by a single man that's not what we say
6:48 what do we say we say brah GG Noob
6:50 you're whipped I guess we'll never see
6:51 you again and we're smiling the whole
6:53 time we're not like
6:55 why don't you text me anymore I know you
6:56 haven't been texting me I feel hurt
6:59 instead what we do is we actually dog on
7:00 this guy right we're like we call him
7:02 whipped and we call him a wuss and we
7:04 call them like we say all these negative
7:06 things right like oh where's the Apron
7:07 Strings we'll say all this like
7:09 misogynistic crap but the whole time
7:12 we're like expressing appreciation and
7:14 smiling at him so men have this negative
7:17 expression of a positive affection when
7:19 we feel good about something we can't
7:21 just say that right because that's not
7:23 what we were taught instead of what we
7:24 have to do is we have to insult the
7:27 person that we're proud of
7:29 that's not how Psychotherapy works right
7:31 so if this is my mode of communication I
7:32 go see my therapist and my therapist is
7:34 proud of me they don't say hey [ __ ]
7:37 you got a job you suck I guess you're
7:38 not going to be coming to therapy
7:39 anymore because you ain't got this time
7:42 because you got all this this work to do
7:44 you know Screw you that's not what your
7:46 therapist says in fact we're trained to
7:47 say the opposite so the way that we're
7:49 trained to speak in therapy is first of
7:52 all don't speak very much right don't
7:54 solve problems just sit there and listen
7:57 and ask this person lots of questions
7:58 that they're gonna say I don't know to
8:00 how do you feel about that how does that
8:02 make you feel I don't know well how does
8:03 that make you feel
8:06 I don't know and so then if you're a
8:07 dude and you go to therapy you feel like
8:09 an idiot right because they're asking
8:10 you all these questions you're supposed
8:13 to know what you feel but you don't know
8:14 and that's because of the way that we've
8:16 been taught about our emotions the last
8:18 thing to consider is that when it comes
8:20 to emotional health men are very
8:22 physical with it so even if I ask a dude
8:25 hey like you know you're it sounds like
8:27 you got dumped tell me a little bit
8:28 about how you feel the dude may not be
8:31 able to say I feel unlovable I'm full of
8:35 fear that that perhaps I I won't be able
8:37 to find a partner I'm afraid that I'm
8:40 fundamentally broken in some way that
8:42 precludes me and maybe destins me to be
8:44 alone for the rest of my life that's not
8:46 what dudes say what dudes say is it felt
8:48 like she ripped my heart out it felt
8:50 like she stomped on my balls and if you
8:53 say that as a dude the other dudes will
8:55 know exactly what you mean right like we
8:58 all know like oh man like oh it's not
8:59 just ripped your heart out it's also a
9:01 stomp on the balls I felt that man the
9:02 last time I got dumped I found out my
9:04 partner was cheating on me felt like she
9:05 kicked me in the nuts dude I know
9:07 exactly how you feel that's how we talk
9:10 we're very physical in nature the other
9:12 thing is if you talk to men about who
9:13 support each other right and they say
9:14 say if you get dumped what's the first
9:17 thing you should do hit the gym baby and
9:19 that's where we may assume that there
9:21 that this relates to confidence that if
9:22 you start working out you get buffed and
9:24 you look at yourself in the mirror and
9:26 you're like I'm so sexy but we don't
9:27 even acknowledge for a moment that there
9:30 may be a physiological aspect to improve
9:31 your mood and one of the biggest
9:33 mistakes that I think we've made in the
9:34 field of psychotherapy is that we've
9:36 separated out the Mind from the body
9:39 whereas if you look at modern science we
9:41 know that anxiety is not just an emotion
9:44 it's not just in your mind that emotions
9:47 have physical ramifications that anxiety
9:49 can induce diarrhea and change the rate
9:52 of your peristalsis anxiety activates
9:54 your sympathetic nervous system and
9:56 reduces blood flow to places like your
9:58 stomach and increases blood flow to
9:59 other parts of your body
10:01 so we know that emotions are actually
10:04 very physiological in nature so why is
10:05 it as a society that we've kind of
10:07 gotten on this track of simply talking
10:09 about them instead of acting physically
10:11 and a lot of the men that I've worked
10:12 with I've sort of noticed that this
10:15 physical component is way more important
10:17 than the talking component at least
10:18 compared to the women that I've worked
10:19 with just to give you all a simple
10:22 example I find that the men in my office
10:26 need hugs way more than the women now
10:27 there are a lot of complications to that
10:29 there's a gender Dynamic right between
10:30 me and the woman where maybe the woman
10:32 doesn't feel as comfortable to hug me
10:34 maybe I don't feel as comfortable to hug
10:35 the woman so I'm not saying that that's
10:37 like a statement of fact but what I've
10:40 noticed is that like hugging men the the
10:41 patients in my office who are dudes
10:44 leads to like a lot more emotional
10:46 healing and sometimes tears and all this
10:48 kind of stuff and like more dick jokes
10:49 after we're done right so there's
10:51 something very physical about the way
10:54 that men deal with their emotions
10:56 and so if we assume all of this is true
10:58 what does this mean for you as a dude so
11:00 I know this sounds kind of weird but the
11:01 first thing that I'd recommend is that
11:04 you actually seek Psychotherapy if
11:05 you're struggling in some way and that
11:07 may sound weird because you said Dr K
11:09 there's a systemic bias yeah but it's
11:11 still the best evidence-based treatment
11:13 that we have for dealing with mental illness
11:14 illness
11:16 medication is just as good by the way
11:18 and another thing we need to keep in
11:19 mind is that there are randomized
11:21 controlled trials on many types of
11:23 psychotherapy which show that they are
11:25 equally effective for men and women so
11:27 it's not like Psychotherapy works it's
11:28 just that if you're engaging in
11:30 Psychotherapy as a man there may be a
11:32 couple of things that we can arm you
11:34 with to really make that Psychotherapy
11:36 really worthwhile
11:37 so the first recommendation that I have
11:39 is that you see at least three
11:41 psychotherapists or at least you see at
11:42 least three
11:44 before you give up on therapy if you
11:45 love the first one then stick with them
11:47 and so a lot of psychotherapy is about
11:49 fit and it may just be hard to find
11:51 someone who's able to communicate with
11:54 you in a way that is helpful so a couple
11:55 of things that I would recommend some
11:57 language that you can use if you go to
11:59 psychotherapy so the first is just
12:01 simply let your therapist know hey I'm
12:04 not really aware of what I feel all the
12:05 time and I'm not very good at
12:07 articulating my feelings because
12:09 oftentimes therapists will say how do
12:11 you feel and as dudes we don't know how
12:13 to answer that so just be transparent
12:15 with them at the beginning another thing
12:17 that I recommend is that you all check
12:19 out this idea of normative male
12:21 alexithymia which is this idea that men
12:24 or by default it's normative so it's
12:26 like most men are colorblind to their
12:28 internal emotional state so check out
12:30 our video on Alexa thymia if you all
12:32 want to and then you can even tell your
12:34 your therapist that hey I'm concerned
12:36 that I'm a little bit alexithymic so
12:38 you're signaling to them that you may
12:40 not be able to participate in therapy in
12:42 a default way the next thing that you
12:44 can can do is ask your therapist to
12:46 change their style a little bit if it
12:47 isn't working for you so you can tell
12:48 them hey I've noticed that you're really
12:50 quiet and then you kind of ask these
12:51 questions like how do you feel over and
12:53 over and over again and then I keep
12:56 answering I don't know can you try to be
12:57 a little bit more active or offer a
12:59 little bit more guidance instead of
13:03 being quieter and asking only open-ended
13:04 questions can you help me understand
13:07 software guide me in some way and some
13:08 therapists may feel really uncomfortable
13:10 with that they may turn that around into
13:12 a question why do you feel like you need
13:14 more guidance
13:16 I don't know because this doesn't seem
13:18 to be helping very much so you can just
13:20 ask them to change their style a little
13:22 bit and the third thing that you can do
13:24 if number one and number two don't work
13:26 is after two or three sessions I would
13:27 just go to them and say hey I don't feel
13:29 like I'm actually getting a whole lot
13:31 out of this therapy so you seem to be
13:33 asking certain questions that I have
13:35 difficulty answering and I'm hoping that
13:37 you can recommend a different therapist
13:40 who's a little bit more active can offer
13:42 a little bit more guidance or ask
13:44 questions in a way that can help me
13:46 understand my emotions better and I know
13:50 that this sounds mortifying oh my God as
13:52 a dude why would I ever do that as
13:54 anyone as any patient why would I ask to
13:55 see a different therapist it means that
13:57 I don't think they're good and it
13:59 doesn't mean that they're not good it
14:00 just means that they're not really
14:03 helping you very much or at the minimum
14:05 you can have a conversation about what's
14:06 working and what isn't and then
14:07 hopefully you all can work through that
14:10 stuff so I as a therapist actually don't
14:12 feel I mean I feel bad in some ways but
14:14 I'm really grateful for all of my
14:15 patients who have come to me and said
14:18 hey Dr K this is not working because
14:20 then one of two things happen one is
14:21 either we work on it and then we
14:23 actually make a breakthrough of some
14:24 kind and now we're really jiving
14:27 together or I recommend that the person
14:29 go see someone else and what's my duty
14:31 as a doctor or someone's Duty as a
14:34 therapist it's to help the person not
14:35 help the person myself
14:37 it means giving that person whatever
14:39 kind of help they need
14:41 so oddly enough I'm still recommending
14:43 that you'll try Psychotherapy because it
14:45 is still an evidence-based very
14:46 effective approach
14:48 the other thing to consider though is
14:51 that a lot of emotions live in our body
14:54 and as men sometimes we need to do more
14:56 bodily stuff so there are studies that
14:59 show that Tai Chi and yoga for example
15:01 are effective treatments for a lot of
15:03 things like mood disorders or anxiety or
15:05 things like that so adding a physical
15:08 component to your emotional health is
15:10 very very helpful the other thing to
15:13 consider is that there's a range of new
15:15 and kind of in Vogue things called
15:18 somatic therapies so these are therapies
15:21 that incorporate the body in some way so
15:24 good examples of this are EMDR or EFT
15:26 which is the emotional freeing technique
15:28 or tapping so when I first encountered
15:30 these studies about 10 or 15 years ago
15:32 and I used to sort of my area of
15:33 Interest was evidence-based
15:35 complementing alternative medicine I
15:36 thought all this stuff was like kind of
15:39 BS right so it's like the idea behind
15:40 tapping is that your emotions are stored
15:43 in your body and that you can tap on
15:45 certain parts to free emotions and I was
15:46 like this doesn't make any sense I'll be
15:48 yes and it turns out that over the last
15:50 decade or so there have been some
15:51 studies that actually show that this is
15:53 a pretty effective technique we're not
15:55 really 100 sure you know the studies
15:57 aren't super high quality but there's
16:00 more and more evidence that stuff that
16:02 is not classically effective may be
16:04 effective and specifically that a lot of
16:06 somatic therapies seem to be gaining a
16:08 lot of weight and gaining a lot of
16:10 interest so I encourage you all to seek
16:13 out more bodily oriented kind of
16:15 evidence-based techniques
16:16 and the last thing that I just want to
16:18 share with you all is that I've seen
16:20 that across the globe there's a lot more
16:22 men's work kind of going on and this
16:24 isn't psychotherapy but it's just sort
16:26 of groups of men will get together and
16:28 will participate in all kinds of either
16:30 communication or even like some sorts of
16:32 like physical rituals or like taking
16:34 hikes there's sort of this very like
16:37 physical component to to their emotional
16:39 health which they all sort of get
16:41 together and do so I can't speak to
16:42 specific things like that I'm just sort
16:45 of pointing that out is a trend so at
16:46 the end of the day I know it sounds kind
16:48 of weird but I do think that therapy
16:51 sucks for men for a lot of reasons some
16:52 of that has to do with the way that
16:53 we're raised some of that has to do with
16:56 the way that Psychotherapy was developed
16:58 and so as men we sort of really need to
16:59 think a little bit about how can I
17:01 become emotionally healthy so I
17:04 definitely give therapy a shot but go in
17:05 with some of these disclaimers in mind
17:08 go in understanding that you may not be
17:10 perfectly suited to this that you're
17:12 stepping onto the basketball court but
17:13 you don't necessarily know how to
17:16 dribble and so just recognize that and
17:17 ask your therapist for help and the
17:19 second thing to consider is that
17:20 especially as men a lot of our emotions
17:23 live in our bodies we may need to
17:25 leverage our bodies or do some kind of
17:28 bodily work to really help us achieve
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