Video summary
Therapy often struggles to resonate with men due to a fundamental misunderstanding regarding how emotions should be processed and resolved. Historically, there has been an assumption that discussing feelings is the primary mental health intervention, yet this approach relies on selection bias because it overlooks those who leave therapy or never seek help in the first place since talking about emotions did not work for them. Furthermore, the therapeutic landscape is skewed by demographics; most therapists and patients are women, leading to a generalization that emotional talk works universally without distinguishing between male and female needs. Consequently, men often feel alienated because they prefer instrumental support—problem-solving strategies—rather than emotionally supportive therapy where feelings are discussed in isolation. The training of mental health professionals actively discourages problem-solving, as illustrated by an anecdote from a psychiatry resident's education where the correct response to a patient asking for help finding a girlfriend was not providing solutions but rather exploring underlying psychological barriers. This disconnect is exacerbated by disturbing data on "diseases of despair," with suicide-related diagnoses in individuals under 18 rising significantly between 2009 and 2018. Research indicates that between 37% and 66.7% of men who commit suicide have no prior history of diagnosed mental illness, suggesting they may not be clinically ill but rather mentally checked out due to unfixable life circumstances driven by economic forces like employment instability or underemployment. To address these issues, the speaker argues that effective help for many male patients involves building a tangible future and achieving material outcomes rather than just alleviating depressive symptoms through conversation. Current therapeutic quality metrics focus heavily on reductions in depression and anxiety scores but fail to measure life-worthwhile achievements such as promotions, marriage, or career stability. This gap has led to the emergence of coaching fields that prioritize action-oriented goals over purely emotional exploration. The speaker notes that when men present with issues like low self-esteem due to unemployment and relationshiplessness, simply talking about these problems is insufficient; they require assistance in constructing a life path forward. Evidence-based methods for predominantly male diagnoses often align better with this need for action than traditional talk therapy suggests. For instance, motivational interviewing used for addiction treatment focuses on increasing motivation to act rather than examining dreams or feelings, demonstrating that therapeutic technology can be instrumental and goal-directed. In these contexts, emotions are viewed not as the end goal but as a means to understand how negative states prevent individuals from achieving their objectives. The discussion concludes that while traditional therapy has its place, there is a distinct need for approaches that integrate coaching principles to help men solve practical problems and rebuild their lives in response to modern economic challenges. The segment also includes a sponsorship message regarding Momentus, highlighting the speaker's personal experience of increasing his testosterone levels from 495 to 1006 through specific supplements like Fido Aesus and Tonat Ali. The sponsor emphasizes that unlike many other products, these are NSF certified for purity, making them suitable even for Olympic athletes who must adhere to strict testing standards. Momentus offers a rigorous guarantee where customers can try the product for 29 days with a full money-back refund if unsatisfied, alongside international shipping options and a discount code available via their website link in show notes.
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why does therapy so often suck for men
so there are a couple of reasons for
this the first is that I think we have a
misunderstanding somewhere along the way
we got the impression that talking about
our emotions is the best way to handle
them so I think we have a bias about our
understanding of emotions we think first
of all they're primarily mental secondly
we think that talking about them is the
way to go and therapy is the best
evidence-based approach that we've got
basically historically of dealing with
your emotions but I think there are a
couple of biases the first is that the
majority of therapists are women and the
majority of patients are also women
historically which means that if you're
looking at a population and you say
talking about emotions really works for
my patients if you're just a therapist
we don't really segregate between our
male patients and our emotional our
female patients we sort of like look at
this and we say like this is what works
now there are lots of trials that
actually show the opposite of that so
will have trials on cognitive behavioral
therapy that look at 50% men 50% women
both of them have good effect sizes but
there too I think there's a selection
bias because even if you're looking at
success in therapy you're not counting
all the people who left that didn't go
to therapy in the first place because
talking about emotions did not work for
them there's even a really interesting
um paper uh uh so there's a lot of
exploration into this and and one paper
actually points out that there are two
kinds of therapy that you can give one
is what we call emotionally supportive
therapy where you talk about your
emotions and the second is something
called instrumental support which is
like problem solving and what we tend to
find is that men prefer problem solving
but if you look at therapy training we
are actively disincentivized to problem
solve with our patients we're not there
to solve your problems so when I was
like um a a second-year Psychiatry
resident and and I had this 16we therapy
course where I'm learning the basics of
therapy and you know one of the teachers
came in and was like if a patient walks
in and says can you help me find a
girlfriend what's the right answer and
then the right answer is that help me
understand why you think you can't find
one help me understand why you want one
let's talk about it the answer is not
yes right so so as therapists we're not
very good as a as a whole profession at
like helping people solve problems and I
think especially if you look at men
there's there's a lot of disturbing data
on diseases of Despair so between I
think like 2009 and
2018 um
suicider related diagnoses in people
under the age of 18 went up by 287 per.
so what's happening right now especially
if you look at male mental health is
we're starting to realize that uh
there's there's another study for
example that there a couple studies that
show that somewhere between 37 and
66.7% of men who commit suicide so
somewhere between 37 and 66% have no
history of mental illness so what we're
starting to realize is there's a very
troubling signal that we're seeing that
people who kill themselves may not be
mentally ill they may actually have a
life that they've just mentally checked
out on they've looked at their situation
they've tried to fix it and they just
have nowhere to go and we're seeing this
especially as we see things like changes
in our economic situation changes in
employment or underemployment there's a
lot of economic forces that are
affecting men and so now the problem is
that especially when I work with my male
patients what I see is sometimes when
they come in they'll say okay I feel
suicidal I have low self-esteem okay
diagnosed with a depression tell me
about your life I'm 30 years old I have
no job I've never been in a relationship
and so like what would this person look
forward to right and so a big part of
helping them is not just talking about
your problems a big part is helping them
build a life and that's not something
we're trained in as therapists does this
require an entire new type of therapy it
it almost to me based on what I know
about the definitions of therapy almost
sounds like it gets into some kind of
coaching in a way yes yes so so I I
think that that's why coaching has
emerged as a field right so I think that
what started happening at some point is
therapists stopped focusing on material
outcomes for their patients so if you
look at how we judge the quality of a
therapist it's the reductions in their
depression scores anxiety scores which I
think is completely reasonable right
that like makes sense because that's
what our job is but we certainly don't
measure things like promotion or what
percentage of people get married and
things like that which is if you really
look at like what makes people's lives
worth living it's those kinds of
achievements and even if we look at so
the really fascinating thing is if we
look
at the
evidence-based methods of therapy for
diagnoses that are predominantly men we
see more action so a great example of
this is something called motivational
interviewing so if you look at
addictions the majority of people who
have addictions are men and if we look
at what is the best evidence-based Tech
maybe not best but one very effective
evidence-based technique is something
called motivational interviewing which
is all about getting people to do
it's not about talking about your
feelings it's not we're not going to
examine your dreams or things like that
it's like you have this goal how can I
interview you in a way that increases
your motivation and moves to action so
we actually see that where there are
some diagnoses that are predominantly
men where that the technology that we
use the therapeutic technology that we
use is action oriented is instrumental
and we talk about emotions and stuff but
the emotions is not the end it's a means
how can we understand how these negative
emotions are impacting your actions and
preventing you from achieving what you
want so we absolutely see that signal in
therapy we'll get back to talking to Dr
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