As one of a relatively small number of male couple therapists practicing in the UK, I am particularly interested in how men feel about coming to therapy, be it couple or individual. It’s probably fair to say that the odds are stacked against men in therapy. 

First, an important caveat. I have intentionally generalised in this article. An increasing number of men are used to articulating their feelings in a lucid way. But historically this hasn’t usually been the case, and the shadows of past gendered roles in families can still be seen. 

Another caveat. In this piece I talk specifically about heterosexual couples. Some of this might apply to same sex couples or to those who don’t define their gender in traditional ways. That’s something that would need to be discussed in another article.

Although it seems very old fashioned,  traditionally society has tended to expect women to be ones who talk about feelings, who handle the emotional aspects of parenting, who ‘look after’ the emotions of the whole family, leaving the men to be the breadwinners. While few couples are like this these days, the norms of previous generations can still bear down on families even now. Growing up, many men (as boys) may have been encouraged to express themselves via sport, and many father/son relationships use sport as the currency, with deeper feelings difficult for both to share. 

The roots of modern couple therapy (and individual therapy for that matter) are from Sigmund Freud, who famously treated apparently ‘hysterical’ women as his patients. Society then labelled them as ‘unwell’ because of a profusion of complex and potentially contradictory emotions. Freud tried to make sense of the emotion by encouraging a free-flowing approach. Had he treated men of that era, I suspect he might have often been met with a silent patient, and might well have needed to find other ways of helping such patients express themselves. 

Coming to couple therapy for the first time can be a daunting experience for both women and men, but can be especially uncomfortable for men who might not be used to talking about their feelings. What can help is to find different ways of helping men express themselves. 

Men can often express feelings physically, through body language, facial expressions and tone of voice. This links with the way sport is traditionally how boys are encouraged to express themselves. It’s obviously part of any therapist’s role to identify these often unconscious cues, and to gently explore their potential meaning. 

Allowing men time and space to talk about experiences– how they experience situations, how they experience their partner or their children, their work colleagues too – can open up conversations about the effect the experience. 

Let’s end with a brief fictional example – a couple where the man has just turned fifty, struggling with fitness and finding it hard to keep a healthy weight.  She is a few years younger and has more time for exercise. He experiences his partner as critical and over demanding when she talks about how inactive he’s become. He withdraws from her more, even rebels by sneakily snacking, perhaps a way of asserting his independence while seeking comfort in food. In the therapy room, he can often seem to disengage, to look out of the window, and there are times when it seems he hasn’t been listening. 

Once he can find some confidence in a safe space, and can talk about the experience of being criticised, he can then start to think about the impact of that on him, for example that it makes him feel small or not good enough, perhaps with echoes of his experiences in childhood with his own parents who he fears were disappointed in him. 

Once his partner hears the impact of her words, perhaps together they can start to find a different way of relating – and also to uncover the real issue underneath the conflict – a shared concern about ageing and health, and what the future holds for them individually and as a couple.  This concern can then be turned into a joint plan for chang