I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression

by Terrence Real

The degree to which a man relies upon addictive defenses to ward off depression determines the degree of his abusiveness or irresponsibility toward others. A covertly depressed man cannot afford to be fully responsive to those around him because his primary need lies in maintaining his defense, his emotional “prosthesis.”

While Narcissus was incapable of loving another, the source of his incapacity lay in his lack of self-knowledge. What the defenses in covert depression medicate is the pain of the man’s poor relationship to himself.

Edward Khantzian, the father of the self-medication hypothesis, speaks of addictions as attempts to “correct” for flaws in the user’s ego capacities.

Khantzian and others currently writing on the psychology of addiction speak of substance abuse as a desperate strategy for dealing with self “dysregulation.” Khantzian’s research on both alcoholics and drug abusers led him to focus on four cardinal areas of dysregulation: difficulty in maintaining healthy self-esteem; difficulty in regulating one’s feelings; difficulty in exercising self-care; and difficulty in sustaining connection to others.

Traditional socialization of boys diminishes the capacity to esteem the self without going up into grandiosity or down into shame. Traditional masculinization teaches boys to replace inherent self-worth with performance-based esteem. It insists that boys disown vulnerable feelings (which could help them connect), while reinforcing their entitlement to express anger. It teaches boys to renounce their true needs in the service of achievement, and at the same time blunts their sensitivity to reading the needs of others.

damage in relatedness. And if disconnection from self and others creates suffering, then learning and practicing the art of reconnection can relieve it.

call such a healing instance a moment of relational heroism. Relational heroism occurs when every muscle and nerve in one’s body pulls one toward reenacting one’s usual dysfunctional pattern, but through sheer force of discipline or grace, one lifts oneself off the well-worn track toward behaviors that are more vulnerable, more cherishing, more mature.

recovery process. Jeffrey once teased me that our therapy felt like couples counseling between himself and himself. He threw out the line to tweak me, but, in truth, I felt flattered by it. How does a man like Jeffrey learn to do for himself what his parents could not? He learns from therapy and he learns from other men and women in recovery.

Thinking of maturity as a daily practice is a radical departure from traditional psychotherapy in which the man’s difficulties in relating to himself is envisioned as character pathology, ego dysfunction, or structural deficits.

Rather than attempt to reparent the depressed men I work with, I teach them how to reparent themselves.

They are activities. Self-esteem, for example, is not something one has; it is something one does. And it is something one can learn to do better. I call this part of recovery work the practice of relational maturity. Treatment

Pia Mellody has devised a five-point grid that I find practical and comprehensive. It consists of five self functions: self-esteem, self-protection, self-knowledge, self-care, and self-moderation.

Jeffrey can now close his eyes for a moment, breathe deeply, remind himself that, in his fifties, he is too old to be abandoned. He might imagine himself encircling that internal eight-year-old with his adult wisdom, nourishment, and love. “I am enough and I matter,” he might repeat to himself, quieting his rising panic. “Whether I am accepted or rejected, right now, the person whose job it is to cherish me is me.”

Men like Jeffrey learn the internal technology of first recognizing and then bringing themselves up from shame states; of recognizing and then bringing themselves down from grandiose states.

his connection to others and himself, his thirty-year depression is in full remission. First, he stopped the addictive defenses that stabilized his depression and held it in place. Second, he learned how to parent himself, nurture, guide, and contain himself, on a daily basis. Finally, he delved deep into his early darkness and released the introjected imagery, feelings, and shame he had taken in. Jeffrey Robinson is a hero. No less than Dante, Aeneas, Oedipus, he has descended. And he has emerged.

“On the broad plain of Hell,” I tell him one session, “where the unbaptized philosophers are, where Virgil himself resides, there is no torture.

Yes, there are structural differences between men and women, but the real picture is by no means as simple as one might think. There is some indication, for example, that human males are, if anything, more emotional than human females.

The aversion of many men to strong emotion, Gottman speculates, may not be the result of a diminished capacity to feel, as has been commonly believed, but just the reverse. Because men may bring a heightened biological sensitivity to the experience of feeling, strong emotion might be experienced as aversive, as physiologically overwhelming.

One could make a case that racism is an extension of xenophobia, the contempt for strangers, and thus may have strong biological roots. But, one rarely hears a passive, fatalistic acceptance of racism.

But I have yet to hear anyone claim that we should accept the inevitability of attack and molestation in blended families because men are just biologically wired for that behavior. There is, in humans, a force whose job it is to ameliorate raw

Both forms of depression in men, overt and covert, frequently evoke in mates an urge to protect their husbands.

Any woman knows that few strategies serve to “build up” a male more effectively than her own appearance of helplessness.

while single men are the most at-risk population in the nation for both physical and psychological health problems.

Bernard reviews dozens of studies and government statistics on health and concludes that contemporary marriage appears to be beneficial to the well-being of men and detrimental to that of women.

Jessie Bernard and dozens of sociologists who have followed her are correct, then a wife like Judy is an extreme version of the many women who are willing to become symptomatic themselves while their husband’s symptoms decrease.

No one benefits when women protect depressed men’s disconnection in this way.

Like many children from chaotic homes, even though my father was the flagrant abuser, my most unresolved feelings are reserved for the parent who refused to protect me. While I know intellectually that my feelings toward her might be unfair, they nevertheless remain less forgiving than those toward my dad.

In preparation for the ritual beatings, Mother would be brought into the room to watch. They had learned somewhere that it was important to present a united front to the children.

To help a depressed woman means facilitating her rise against the forces of oppression that surround her. To help a depressed man, one needs to invite him to step up to increased relational responsibility, a move he may not be inclined to make if his partner allows him to avoid it.

In any given quest, not one but many knights venture forth. Some get further than others. Some do not make it at all.

“feminine” vulnerabilities but, like Joe and his father, couple them with a “masculine” entitlement to behave irresponsibly. In covert depression, the man cannot afford to be relationally responsive either, for three reasons. First, his primary allegiance must be to the defenses he uses for self-regulation. Second, intimacy with another will inevitably trigger intimacy with himself—an intimacy many covertly depressed men prefer to avoid. Finally, because relational skills have frequently lain dormant and unexercised, demands for intimacy initially exacerbate the feelings of inadequacy that may already plague him.

I tell the wives of depressed men: “If you directly confront this condition and do not back away from reasonable demands for intimacy, there may be a fifty-fifty chance your husband will leave you. But, if you do not honestly engage with these issues, there is a ninety percent chance your relationship will slowly corrode over time. Which risk would you prefer to take?”

Work with depressed men and their partners has convinced me that men’s much-vaunted fear of women and of intimacy is really not a fear of either. What men fear is subjugation. In the one up/one down, better than/less than, hierarchical world of traditional masculinity, one is either in control or controlled. Vulnerability, openness, yielding to another’s wishes—many of the requisite skills for healthy relationships—can be experienced by men as invitations to be attacked. Men’s fear of entrapment, of female engulfment, is not really about women at all. It is a transposition of a male model of interaction to the living room and the bedroom. When men fear that their women will “engulf” them, they fear that their women will act like men.

“Honey, I’m just too drained to listen right now. But I’d be happy to hear more over breakfast tomorrow.” These rudimentary skills of communication, direct assertion, and accountability, are easily learned, taught by therapists all over the country.

The good news is that once a man has a few of such elementary skills under his belt—particularly if he is working in conjunction with an equally committed partner—the relationship shows quick improvement. And improved relationships often help alleviate the man’s depression.

It was clear to me that, just as I learned about individual therapy in order to figure out what to do with my pain, I was now learning family therapy in order to figure out what a healthy relationship looked like. As is true of most of the men that I treat, my family certainly did not teach me what I needed to know in order to sustain satisfactory intimacy. And society at large had not taught me these skills either.

do believe that any man who has struggled in his life with a deep, core experience of depression will need help not only in learning how to cherish himself, but also in learning the art of cherishing others. Just as the beam of contempt, the internalized dynamic of violence, may sometimes turn inward in overt depression, sometimes outward in covert depression, the regenerative force of recovery must turn inward toward increased maturity, increased self-regulation, and outward toward increased relational skill. Recovery, at its deepest level, evokes the art of valuing, caring for, and sustaining. The relationship one sustains may be toward oneself, toward others, or even toward the world itself.

speak to men of this shift in life orientation as the move into fathering. Fathering, as I speak of it, can, but need not, involve the biological begetting of children. Fathering need not involve children at all. Fathering occurs when the essential question a man lives by changes.

The essential shift in question that marks a depressed man’s transformation is the shift from: What will I get? to: What can I offer?

The greatest cost of the less than/better than dynamic of traditional masculinity lies in its deprivation of the experience of communion. Those who fear subjugation have limited repertoires of service.

Discipline means “to place oneself in the service of.” Discipline is a form of devotion. A grown man with nothing to devote himself to is a man who is sick at heart.

This culture, with its reliance on performance-based esteem, gives men few models for healthy sacrifice.

Most men understand the wisdom of relationship, of sacrifice to larger goals, in relation to their careers. But it takes some effort to transpose this same wisdom to the care of their families, their marriages, their friendships, and even their own health.

This may have less to do with boys’ needs for fathers than with the men’s need to be fathers, to live for something beyond performance, kudos, and acquisition.

It is becoming increasingly apparent that the old paradigm of worth through dominance, of valor, is atavistic. It no longer fits our complex, interdependent world.

In The End of Victory Culture, political commentator Tom Engle-hardt posits that with the explosion of the first atom bomb on Hiroshima, European culture entered a new historical stage. Nuclear warfare made it abundantly apparent that conquest and frontier were not endless propositions.

culture of limitless resources and limitless conquest had reached an undeniable boundary.

We face global threats. The paradigm of dominance must yield to an ethic of caretaking, or we simply will not survive.

The dynamic of dominance and submission, which has been at the heart of traditional masculinity, can play itself out inside the psyche of a man as depression, in his interpersonal relationships as irresponsibility and abuse, in one race’s contempt for another people, or in humanity’s relationship to the earth itself.

Gore’s prescription for the species is recovery: If the global environmental crisis is rooted in the dysfunctional pattern of our civilization’s relationship to the natural world, confronting and fully understanding that pattern . . . is the first step toward mourning what we have lost . . . and coming to terms with the new story of what it means to be a steward of the earth.