Why men don't seek help

The first hurdle some men face is that they may be so out of touch with their emotions that they do not even realize that they are, for example, depressed.

Many boys, he says, learn from their parents and from other children that they are not supposed to express vulnerability or caring. They learn to suppress their emotional responses--like crying or even sad facial expressions--so much that, by the time they are adults, they are genuinely unaware of their emotions and how to describe them in words.

• Masculine role socialization. To benefit from counseling, a man must admit that he needs help, must rely on the counselor and must openly discuss and express emotion. These requirements, says Mahalik, conflict with traditional ideals of what it means to be male: toughness, independence and emotional control.

• Social Norms. Some men may also worry that society will look down on a man who can't "tough it out" on his own, and that seeking--or even needing--help is not "normal" male behavior. Even men who do seek counseling may worry about what others think of their choice, including Tim (a pseudonym), a client of Good's in his 50s who began therapy after he ended an extramarital affair.

What can be done?

One way to convince more men to seek help, then, is to convince them that the things they need help with are "normal."