Why Do Twice as Many Women Seek Therapy by Dr. Deb Hirschhorn

Dr. Deb

Why Do Twice as Many Women Seek Therapy As Men?

By Deb Hirschhorn, Ph.D.

According to the CDC (Centers For Disease Control), about a quarter of the American population of women will seek therapy services in a given year and only half that percent of men will do so.

Why is that?

Is there something innate in women that drives them to get help?

Or are women more “sick” than men?

Or is there something else?

I’ve mentioned here Dr. Richard Schwartz, the creator of Internal Family Systems. He co-authored a book in 2002 called The Mosaic Mind. In that book, he applied his IFS model to a woman who had had severe childhood abuse.

Although he focused on one particular person who was the victim of a specific type of abuse, my own focus in my professional life on emotional abuse makes me think that his findings are applicable to any abuse.

Furthermore, let’s get away from thinking that “abuse” only means physical abuse or severe emotional maltreatment.

Moreover, when a person is abused, it is traumatic and their trauma reactions will prevail for their whole lives. Many people seem to overcome these reactions due to their resilience. Nevertheless, there are scars that remain hidden – but the scarred person will have unexpected “reactions” to normal life which give away the fact that there has been trauma.

Bessel van der Kolk said that mistreatment on a daily, low-level basis – such as a parent not being home when the young child gets there, or a parent dismissing the child having been bullied – may be more traumatic in the long run than, say, being in a car accident. That’s abuse. And that’s trauma.

The daily grind of coming home from school to a home where one parent is mentally ill, living with the shades always drawn and never smiling, is abusive too, whether the parent intends it or not. Similarly, fighting between parents is also traumatic.

In our society, this is brushed off as “normal” and children going through it should “get over it.”

Well, they do.

They move on, of course. They grow up, hold responsible positions in the external world, get married, have kids, and all the while, there’s something sore and painful deep inside.

Now, here’s where the men and women split off.

Twice as many women as men acknowledge that pain inside and seek help for it.

Men in our society are not allowed to feel pain. As Terry Real says in How Can I Get Through to You? Closing the Intimacy Gap Between Men and Women:

I have come to believe that violence is boyhood socialization.

The way we “turn boys into men” is through injury. We sever them from their mothers, research tells us, far too early. We pull them away from their own expressiveness, from their feelings, from sensitivity to others. The very phrase, “Be a man” means suck it up and keep going. Disconnection is not fallout from traditional masculinity. Disconnection is masculinity. (p. 78)

In Schwartz’s terms, their “managers” – those parts of them that try to help keep them going on with ordinary life so they don’t have to experience their pain – devise all kinds of ways to stop them from exploring the causes of this disconnection. That is why they don’t show up in therapy.

They, literally, can’t. The internal cost – from the way their managers see it – would be too high. They, themselves, remain unaware of the internal battle.

So that sounds good, right? It protects them, and they don’t even realize what’s going on.

Wrong.

They will tell you they feel “fine.” But what they don’t feel is • Compassion for those they hurt because, half numb, they don’t know they’re hurting someone • Joy (because they’re quite numb emotionally) • Connection to themselves, so they’re unaware of why they have reactions that seem strange to others

But the men are willing to live with this state of being. They’re willing to be partially numb, have partial joy, lack compassion when their explosions hurt others, and dedicate their energies instead to distractions like work or worse. Their managers prefer this state to revealing to them the truth of their histories.

That is why so many, many men will say, “I don’t remember my childhood” or “My childhood was happy” when it wasn’t, and their sister or wife will remind them otherwise.

Yes, women can and will do the same things, but men more so. For instance, according to the volume he co-authored with Regina A Goulding, back in 2002, The Mosaic Mind: Empowering the Tormented Selves of Child Abuse Survivors, they may do the following (see p. 117): • Rationalizing by saying things like, “Dad couldn’t help himself; he was an anxious person.” • Minimizing by saying, “This type of thing happens all the time – it’s no big deal.” • Joking inappropriately • Spacing out and then saying, “I knew mom was talking to me on the phone yesterday but I kept staring out the window and forgetting who I was talking to” • Denying the problem, “I’ve pretty much resolved my abuse-related problems myself” • Forgetting by saying, “My sister tells me she saw it but I just don’t remember anything.” • Blatantly ignoring results by saying, “So I have a few extra drinks at the kiddush. I am not drunk!”

I’d just finished reading the above

and put down the book to start working. I had a client couple call and I asked the husband, “How are you and your wife doing with things that used to trigger you?”

We’ll call him Charlie. Charlie said, “Fine.”

Me: What do you mean by “fine”? Can you be more specific?

Charlie: Well, in situations that she would trigger me, she doesn’t anymore.

Me: Like, give me an example.

Charlie: I can’t remember specif-

Almost as if he’d read the page of this book, right? I was so impressed with how much he sounded like the book, that I read that page to him. Naturally, he laughed.

See, when managers (who come into being when we are children) learn to not attend to pain and forget it quickly when it happens, that learning process doesn’t go away when the person grows up.

But I gave Charlie the homework – and this wasn’t the first time – to write down the words that would go back and forth in the interactions with his wife and then write them down.

As if on cue, he argued with me that he wouldn’t necessarily carry his notebook around with him – anoth-

er way to avoid the entire subject of pain. I reminded him that he could take notes in his phone using email or Google docs.

Charlie had had a severe upbringing, and I won’t go into details here. But his “managers” became masters at directing his attention elsewhere whenever something emotional came up. Before I was working with this couple, they’d fight. They no longer do. That’s excellent. There’s work done and more work to be done, however.

I give Charlie full credit, though. He shows up. He wants the marriage

to work. He plumbs the depths from time to time. Bottom line: He wants to correct things. Good for him. He’s one of the 12% of men that listen to their wives and head to counseling when things get rough.

I have a Facebook group which is kind of like getting my articles three times a week of which one time is live. It’s called Love Yourself Love Your Marriage for Couples Committed To Connecting. The interesting thing is that out of about 750 people in it, I think there are fewer than 10 men.

Yet, many men have approached me for help. The unfortunate part is that they do so after their wife has made up her mind to divorce. The horses are then out of the stable. It’s very sad. That’s when they put effort into working on themselves, so they’ve started to connect with their – and other people’s – feelings just in time for the next wife.

Which men out there will do what it takes to fix the marriage – and get to know themselves better in the process?

He’s one of the 12% of men that listen to their wives and head to counseling when things get rough.

Dr. Deb Hirschhorn is a Marriage and Family Therapist. If you want help with your marriage, begin by signing up to watch her Masterclass at https://drdeb. com/myw-masterclass.