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

by Terrence Real

While Thomas kept a clear focus on his “life goals,” the future he wanted, he had utterly disregarded his history. He had turned his back on the past he no longer wished to be a part of. The problem with his strategy of disowning pain was that his feelings did not cooperate very well. David Ingles turned his back on the depressed, vulnerable boy inside himself, only to wind up replaying the scene of his injury with his own son. Thomas, in one of those many dark moments by his mother’s bedside, had no doubt made a vow never to subject his future family to anything like his own experience. But the life he provided his family turned out to be almost as out of balance in its own way as the life from which he had escaped. While David’s disavowal pushed him toward violent engagement, Thomas’s disavowal pushed him toward neglect. Both men, with no malevolent intent, inflicted on their families a version of what they themselves had been through.

The only real cure for covert depression is overt depression. Not until the man has stopped running, as David did for a moment that day in my office, or Thomas did when he let himself cry, can he grapple with the pain that has driven his behavior. This is why the “fix” of the compulsive defense never quite works. First, the covertly depressed man must walk through the fire from which he has run. He must allow the pain to surface. Then, he may resolve his hidden depression by learning about self-care and healthy esteem.

When Jimmy lashed out at Shirley, he was, as one abuse expert terms it, “offending from the victim position.” This is perhaps the most common pattern of male violence toward women. Flooded with depression and feelings of victimization, Jimmy used rage to physiologically pump up his sense of deflation. Research shows that rage simultaneously releases adrenaline, which speeds up the autonomic nervous system, and endorphins, which act as the body’s own opioids. This is a powerful internal cocktail, which tragically, like any other form of intoxication, can offer short-lived relief from the pain of depression.

One wonders if a similar impulse may in part lie behind the universal brutality of boy’s initiation rites into manhood. Perhaps the male community’s tradition of “welcoming” a boy into its midst by hurting him is not just a test to prove the boy tough enough to be worthy of joining. Perhaps it is also a demonstration, a need to communicate the men’s own sense of woundedness, a ritual dramatization of how much pain they all carry inside.

The defenses one chooses to avoid shame often afford relief while breeding more shame. Addiction experts have termed this pattern a “shame cycle.” The covertly depressed man’s defensive maneuvers or addictions can be experienced by the man as shameful in themselves or else they can create difficulties in his life that intensify his sense of inferiority, leading in either case to an increased craving for the defenses.

For the covertly depressed man, what lies at the center of the defense or addiction is the disowned overt depression he has run from. And in the center of the overt depression lies trauma.

Childhood injury in boys creates both the wounds and the defenses against the wounds that are the foundation for adult depression.

Studies about the genetic basis of minor depression, however, proved far less convincing. Dissatisfied with these results, epidemiologist George Winokur tried factoring into his studies not merely dysthymia per se but a conglomerate of dysthymia, alcoholism, and “antisocial personality.” He called this mix Depression Spectrum Disease. In all but a few aspects, Winokur’s Depression Spectrum Disease is another name for covert depression. Winokur found that as soon as one broadened the scope of depression to include these addictive or violent behaviors, the resulting brew, Depression Spectrum Disease, could easily be shown to have a genetic basis.

as a father of sons myself, inculcated as much as anyone else by the mores of masculinity, I know firsthand how easily we slip into the passive traumatization of boys.

The heroic, denying, covertly dependent defenses he erected between himself and his own experience, while possible for a women, strike one as familiarly male; strike one, in fact, as only slight exaggerations of much of what we have come to define as male.

In our culture, almost without exception, boyhood involves being both the recipient and the sometime perpetrator of active trauma. Such boyhood injury operates like a fault line in troubled men, coloring their emotional lives, ready, given the right circumstance, to emerge anew. The wounded boy they think they have long left behind acts like a reservoir of hurt and shame. Precisely to the degree to which that boy is not consciously felt and confronted, a man’s hidden depression will permeate his actions.

By not attending to boys’ relational needs—the need for connection, for nurture, support, the expression of vulnerability—we teach them, through passive injury, that those needs are not quite legitimate.

And so the chain goes, across generations, link to link. Whether he knew it or not, my father was doing more than meting out punishment for imagined infractions. He was teaching me, just as he had been taught, what it means to be a man.

Their developing sense of their own masculinity is not, as in most other forms of identity development, a steady movement toward something valued so much as a repulsion from something devalued. Masculine identity development turns out to be not a process of development at all but rather a process of elimination, a successive unfolding of loss.

Those boys who do have fathers are happiest and most well adjusted with warm, loving fathers, fathers who score high in precisely “feminine” qualities. The key component of a boy’s healthy relationship to his father is affection, not “masculinity.” The boys who fare poorly in their psychological adjustment are not those without fathers, but those with abusive or neglectful fathers. Contrary to the traditional stereotype, a sweet man in an apron who helps out with the housework may be just the nurturant kind of father a boy most needs.

Noting the high prevalence of crisis in the lives of people who have histories of trauma, he hypothesizes that some may seek intensity to “self-medicate” internal pain not by reaching for an external stimulant, but by throwing themselves into extreme states of physiological hyperarousal. Trauma survivors may develop dependency on the release of their body’s own “drugs.”

“There’s an old saying in family therapy,” I told him. “They say it takes three generations to heal from trauma. Your dad never made it and you’re in the middle. Let’s see what bringing in your children can do.”

He passed through his fear and mistrust enough to sit still and rest inside his own family. The most courageous act of this shielded man was the surrender of his armor.

Finally, to the degree to which a man learns to “be strong” and to devalue weakness, his compassion toward frailty not just in himself but also in those around him may be limited or condescending. In this and many other ways, the loss of expressivity and the loss of vulnerability inevitably lead to diminished connection with others.

The theme of the powerful disconnected male proving his worth through the violent rescue of the dependent female is a drama endlessly replayed in our culture.

It is this pervasive social influence which belies our attempts to raise our children differently than we were. Many, myself included, have made great efforts to keep their sons and daughters out of the traditional mold. Many encourage their sons to cry when they are upset, encourage their daughters to climb trees.

For close to a month, Billy “just didn’t have it” to get himself to many of his classes, let alone to the library. The few friends he had made were steadfast enough, although he was convinced he was boring to be around. When alone, he ached to be with other people. When with other people, he felt alienated and burdened—out of step—and he spent much of his time wishing they would just go away.

My focus in treating depressed men has been primarily relational. What kind of relationship does a depressed man have with others? I ask, followed by: What kind of relationship does he have with himself?

If “boy culture” exposes most young males to some degree of psychological injury, those growing up in especially difficult circumstances, particularly those also possessing genetic vulnerabilities, are most at risk for depression later in life. The violence they are exposed to as children takes up residence inside their minds as adults.

If overtly depressed men are paralyzed, men who are covertly depressed, as I was, cannot stand still. They run, desperately trying to outdistance shame by medicating their pain, pumping up their tenuous self-esteem, or, if all else fails, inflicting their torture on others.

Billy Jodein’s case provides great insight into how trauma metamorphoses into depression. The first clue of his condition is an absence rather than a presence—an absence of feeling for himself.

In depression, the childhood violence that had been leveled against the boy—whether physical or psychological, active or passive—takes up permanent habitation within him. The depressed man adopts a relationship to himself that mirrors and replicates the dynamics of his own early abuse. This phenomenon, which I call empathic reversal, is the link connecting trauma to depression.

When a parent traumatizes a child, he is in a state of shamelessness. If the injurer felt appropriate shame, he would contain his harmful behavior. The shame a parent does not consciously feel will be absorbed, along with other unconscious feelings, by the child. Pia Mellody has called these transmitted states carried shame and carried feeling. They are the means by which the wound, the legacy of pain, is passed from father to son, mother to son, across generations. Carried feeling and carried shame are the psychological seeds of depression.

Psychoanalytic theory emphasizes the projecting person’s repudiation of his own feelings. The process is described as one wherein a person injects into another the disowned aspects of his own personality. When my father took a strap to me he beat into me his unacknowledged misery. My father hated and punished his own weak, dependent child in me, and I absorbed into my psyche both the hated and the hate-filled parts of him. I took on his sadness, depression, and rage.

The vulnerable part of the self must be protected, encouraged, and nurtured. Both internal children—the wounded boy and the harsh boy—must learn nuanced maturity and responsibility.

Anyone who has listened closely to the voices of depressed men themselves would not be surprised to learn that one medication can treat both depression and obsessive disorders. Depression is an obsessive disorder. A depressed person is endlessly caught in the chains of his rehearsed inadequacies.

In this culture, the lost boy, the shame-ridden, wounded victim, is “feminine.” The punishing judge, the better-than, perfectionist offender, is “masculine.” When our culture teaches boys to repudiate the “feminine” in themselves, to hold that part of themselves in contempt, we teach them to split themselves in half. Each half takes on an assigned role—roles that look very much like traditional gender stereotypes.

Through the mechanism of carried shame and carried feelings, the unresolved pain of previous generations operates in families like an emotional debt. We either face it or we leverage our children with it. When a man stands up to depression, the site of his battle may be inside his own head, but the struggle he wages has repercussions far beyond him. A man who transforms the internalized voice of contempt resists violence lying close to the heart of patriarchy itself.

Each man is a bridge, spanning in his lifetime all of the images and traditions about masculinity inherited from past generations and bestowing—or inflicting—his own retelling of the tale on those who ensue. Unresolved depression often passes from father to son, despite the father’s best intentions, like a toxic, unacknowledged patrimony.

Men who do not turn to face their own pain are too often prone to inflict it on others.

Just as confronting the harsh child involves several generations, so, too, unearthing the lost relational, the vulnerable boy, is both a personal quest and also a drama that may span across generations.

Many sons burdened with carried depression need to plunge into the heart of their own pain in order to find and confront not just their own, but their father’s unacknowledged depression. Because male depression is so often a carried feeling, recovery frequently involves, or at least invokes, several generations of men.

I call this unearthing and healing of the father’s pain, in actuality or in imagination, spiritually healing our fathers. It is the work—done in the presence of the father if he is available, or, if not, on one’s own—of rediscovering the vitality and relationality, the vulnerability, that the father has lost.

I judged my father in much the same way he judged his father before him. The raw emotions I thought were unique to me were, in fact, absorbed, unsettled energies from lives before mine.

I know that the eagle of depression that gnawed at my soul went back at least two generations. The carried shame my father took in was so vast, so profound, that it compromised his capacity to succeed, to feel, to live at all.

For reasons that are a matter of grace, I was filled, early on, with an impulse to turn and face the dark forces that took both these men down. For years, I walked alongside the edge of their abyss, but I never quite fell. Balance prevailed. I had an instinct not to follow in their footsteps. As was true for my father and me, for Henry Duvall and his children, and for all of the men that I treat, recovery from overt and covert depression acts like a circuit breaker. Healing interrupts the legacy of depression’s transmission from parent to child. Like the young knight who must find himself by bringing rest to an anguished king, depressed men, by healing themselves, bring peace to their ancestors and protection to their offspring.

The path of recovery is a demanding one. Left to oneself, one might well shrink from it. But few of the depressed men I see are left to themselves. They have wives, partners, friends. And they have children. The challenge recovery from depression poses to them can seem frighteningly vast at times, but the stakes are very high.

Once a man resolves to take up his hero’s journey, real therapy can begin. Our descent occurs in three phases. First, the addictive defenses must stop. Then, the dysfunctional patterns in the man’s relationship to himself must be attended to. Finally, buried early trauma must reemerge and, as much as possible, be released.

Just about anything can be used as an addictive defense—spending, food, work, achievement, exercise, computer games. When a man with covert depression uses something we normally think of as benign, or even as positive, like work or exercise, it seems almost laughable to insist on questioning the function of that activity in his life. But ordinary activities used as a defense against depression can have wide-ranging consequences.

The depressed man’s relationship to self-esteem becomes proactive, as does his relationship to boundaries, getting in touch with his feelings, dependency, and moderation. In moments like the one Jeffrey describes, the depressed men I work with learn to do therapy on themselves, over and over again, seven days a week.

the depression I had managed to hold at bay while I lived at home thoroughly overwhelmed me almost as soon as I escaped. I spent whole days in bed, paralyzed by depression,

That year was like being frozen in cold, except that I was frozen in pain. As in those nightmares when you can experience everything but you’ve lost control of your body, I remained lucid.

Depression freezes, but sadness flows. It has an end. The thing I had spent so much time avoiding had just swept through me—and I was fine.

Recovery from covert depression must involve three layers—the addictive defense; the underlying relational immaturity or disorder of self; and the childhood trauma that set the whole process in motion. The pain—the depression that the covertly depressed man seeks to escape—results from all three of these phenonomena. Childhood trauma leads to disorders of self-regulation, which can either be felt as overt depression or warded off, acted out, as covert depression.

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.