That is how many men begin their first consultation. The pain is real, but it always arrives under another name and at another address: a friend, a colleague, “a guy I know”.
Why do many men talk about their pain as if it belonged to someone else?
In my clinical experience, talking about a “friend” makes the suffering more distant and therefore easier to bear. Research links adherence to traditional masculinity with more negative attitudes toward seeking psychological help and with greater self-stigma, and shows that men have, on average, slightly more difficulty identifying and describing emotions.
Men’s mental health: when the pain “happened to a friend”
In more than 10 years of clinical practice, women tend to arrive more open to their emotions and more attuned to themselves. Many men, though not all, begin by talking about someone who is far away. If the suffering belongs to someone else, it costs less.
Men have a particular way of dealing with emotions. I remember another patient who, at the most critical moment of his life, cancelled his sessions in order to recover and only then came back, as if showing himself in distress in front of the therapist were humiliating, rather than seen as support and help. There are countless cases I could bring you.
Men and women: attitudes toward psychotherapy
A meta-analysis by Nam and colleagues (2010), covering 16 studies and 5,713 participants in college student samples, found that gender significantly predicts attitudes toward seeking psychological help: women tend to hold more favourable attitudes. The effect is small to medium.
More recently, Üzümçeker’s (2025) meta-analysis of 35 samples linked traditional masculinity to more negative attitudes toward seeking psychological help (r = −0.38) and to greater self-stigma about doing so (r = 0.35). These are moderate correlations, not proof of cause.
Mind what this does not say. In a US national survey of 1,963 people with a mood or anxiety disorder, Susukida and colleagues (2015) found that men sought less help from doctors and informal sources, but were as likely as women to seek mental health professionals. The difference lies mainly in attitudes, and not always in behaviour.
Do men have more difficulty dealing with emotions?
On average, slightly more, but only slightly. In the meta-analysis by Mendia and colleagues (2024), which pooled studies from 2004 to 2023, men scored higher on alexithymia, that is, on difficulty identifying and describing what they feel. The effect was small (d = 0.22) and larger for externally oriented thinking, the tendency to focus on facts and events rather than on feelings (d = 0.49, a medium effect).
In 67 of 139 studies, it was women who scored higher. This is a tendency with a great deal of overlap, not a rule: there are men who are very attuned to what they feel and women who avoid it.
What these data do not say
They measure attitudes, self-stigma and difficulty identifying emotions, not the worth or capacity of any man. The differences are small to medium, with much overlap, and several studies use college students or North American samples. The observations from my clinical practice are exactly that, observations, not data.
Crying at the gym: what a patient told me
A patient told me that, during a period of great suffering, his escape was training at the gym. And that he never cried throughout that whole time. Only in psychotherapy sessions. And at the gym, sweating, when his tears mixed with the sweat.
I have thought about this a lot.
Male grief: the missing space
Even the modern man still has little room for certain emotions. Even when they are essential, as in grief. And grief that is not cried tends to move elsewhere, not disappear.
If you are a man and have ever told a pain as if it were a friend’s, when was the last time you told it as yours?
Frequently asked questions about men and psychotherapy
Do men seek less psychological help than women?On average, they hold less favourable attitudes. A meta-analysis by Nam and colleagues (2010), covering 16 studies, found that women hold more favourable attitudes toward psychological help, with a small to medium effect, and Üzümçeker’s (2025) analysis of 35 samples links traditional masculinity to more negative attitudes and greater self-stigma. But in a US national survey (Susukida and colleagues, 2015), men with mood or anxiety disorders were as likely as women to seek mental health professionals. The difference lies mainly in attitudes.
Why do many men talk about their pain as if it belonged to someone else?There is no single cause. Research points to traditional masculine norms, such as emotional control and self-reliance. In clinical practice, it is common for a first consultation to begin with “this happened to a friend of mine”: if the suffering belongs to someone else, it costs less.
Do men have more difficulty dealing with emotions?On average, slightly more, but the difference is small and there is a great deal of overlap. The meta-analysis by Mendia and colleagues (2024), covering studies from 2004 to 2023, found more alexithymia (difficulty identifying and describing emotions) in men, with a small effect (d = 0.22), and a medium difference in externally oriented thinking (d = 0.49). In 67 of 139 studies, it was women who scored higher.
Is it normal for a man to cry in psychotherapy?Yes. Crying is a normal emotional response in anyone. Psychotherapy exists, among other things, to give a safe space to emotions that find no place in the rest of life, as happens in grief.
Is there a psychologist for men in Lisbon?Yes. Illuminare – Psychology Clinic Lisbon works with men and women in in-person consultations, at Av. Duque de Ávila in Lisbon, and in online consultations. The first consultation is for understanding your situation and defining a personalised therapeutic plan.
Ready to take the next step?
At Illuminare, the first consultation is dedicated to understanding your specific situation and defining a personalised therapeutic plan.
Book an AppointmentReferences
Mendia, J., Zumeta, L. N., Cusi, O., Pascual, A., Alonso-Arbiol, I., Díaz, V., & Páez, D. (2024). Gender differences in alexithymia: Insights from an updated meta-analysis. Personality and Individual Differences, 227, Article 112710. https://doi.org/10.1016/j.paid.2024.112710
Nam, S. K., Chu, H. J., Lee, M. K., Lee, J. H., Kim, N., & Lee, S. M. (2010). A meta-analysis of gender differences in attitudes toward seeking professional psychological help. Journal of American College Health, 59(2), 110–116. https://doi.org/10.1080/07448481.2010.483714
Susukida, R., Mojtabai, R., & Mendelson, T. (2015). Sex differences in help seeking for mood and anxiety disorders in the National Comorbidity Survey-Replication. Depression and Anxiety, 32(11), 853–860. https://doi.org/10.1002/da.22366
Üzümçeker, E. (2025). Traditional masculinity and men’s psychological help-seeking: A meta-analysis. International Journal of Psychology, 60(2), Article e70031. https://doi.org/10.1002/ijop.70031
