Men in Therapy: The External Pressures
This is part two of three. Part one is HERE. These are my observations from the past several years working with men in therapy. Over the past three years, roughly 90-95% of the people I've worked with have been men — so these themes come from a lot of hours in the room with them. This is not a research summary or a how-to guide. Just what I've noticed, in plain language.
Not every man I've worked with has dealt with all of these things — but I've seen each of them often enough to know they matter.
This post reflects general themes from clinical experience and does not describe any individual client.
Many of them have drifted from themselves — and from their purpose
One of the more consistent things I've noticed: men who have become very good at operating in the external world and have, in the process, lost the thread back to their internal one.
They're responsive to demands — of work, of relationships, of whatever the next, assumed goal is. They're good at executing. But ask them what they actually want, what would make their life feel genuinely theirs, and the answer comes slowly if at all. They've been so oriented outward for so long that the inner compass has gone quiet.
Money and success are easy targets to move toward — they come with a built-in scoreboard. More is always better. There's always a next level. You can stay in motion indefinitely without ever having to answer the harder question: what do I actually want, and why? That absence of choice is its own kind of drift and avoidance. And underneath it, usually, is a freedom that feels uncomfortable — the recognition that you get to decide, which also means you're responsible for what you decide. We beg for freedom — and then shudder at the choices we have to make within it.
Most of them, at some level, know that they want more purpose than they currently have. Not in an abstract sense — in a felt sense. A real reason to get up and pursue something that actually matters to them specifically. Early on for most men it's about developing yourself — figuring out who you are through the things you try, the choices you make, the standards you decide to chase. Proving to yourself and others that you're capable. That's real and important work. Later it shifts: a partner, children, a community, or just the love of the thing itself.
That evolution is normal. But the men I'm describing have often lost track of where they are in that process. They’ve stopped making deliberate choices about their life and what they want.
Competition, scarcity, and the disconnection underneath
Men read rooms competitively — who's ahead, who's behind, who has more. That instinct drives a lot. It also creates a quiet scarcity that runs underneath everything. Never quite enough. Never quite there.
Not everything worth competing over is worth competing over for you. Everyone's running a slightly different race — a different version of success, a different set of values, a different life they're actually after. Competing hard to stay ahead in a line you never actually wanted to be in is its own kind of trap.
The tell is this: some of the men I work with have accomplished genuinely significant things — and they're still having the same arguments, the same avoidance patterns, the same reactions to criticism, the same difficulty saying clearly what they want. Achievement changes the circumstances, but the operating system underneath doesn't change unless you change it.
We position ourselves ahead of others in many creative ways in order to defend. When competition tips into grandiosity or superiority, that's usually the defense against inadequacy, not the absence of it. When the noise finally settles, what's often left is disconnection — from other men, from relationships, from themselves.
Staying in your lane — and why it's harder than it sounds
Something that comes up constantly: men spending enormous energy on things that were never theirs to control. Other people's decisions, judgments, lives. It shows up as anger first, then frustration, then a slow resentment that tips into a kind of discouragement and even despair. What's underneath that is usually the exhaustion of trying to manage what was never in their hands to begin with.
This isn't a character flaw. It's a habit of attention, and it usually has roots. But the cost is real. A man spending his energy resenting what someone else has, or managing his anxiety about what someone else thinks, is a man obstructed by himself.
There's a discipline in learning to distinguish what's actually yours to affect from what isn't — and putting your energy there accordingly. When a man stops tracking what everyone else is doing and starts tracking himself — what he wants, what he's building, where he's actually going — there's usually a lot more energy available than he realized.
Squaring up with the clock
Men in their 30s, 40s, 50s — often after a loss close to them, a parent, sometimes a peer — arrive at something they didn't quite see coming. Not just grief. A reckoning. Time is finite.
What I've noticed is that confronting that reality — really sitting with it rather than filing it away — tends to clarify rather than paralyze. The trivial grievances lose their grip. The false urgencies stop feeling so urgent. What remains is usually something more honest: what actually matters, what doesn't, and where the energy is really worth going.
A note on reaching out
If something here landed — in yourself or in someone you care about — that means something.
The first conversation is informal. No commitment, no script. Just a chance to talk about what's going on and figure out whether this kind of work makes sense.
Reach out when you're ready. →
Joe Nord is a Licensed Mental Health Counselor (LMHC) and male therapist in New York, working with men in New York City, Westchester, Long Island, and throughout New York State.