All is fair in love and war.
Your marriage may feel like a little bit of both at times.
When your marriage is doing well, you feel like you are on top of the world. When your marriage is on the rocks, you start to question everything. You see the whole world through a filter of hopelessness and frustration.
When you finally do identify the problem in the relationship, you realize that is only half the battle.
You explain to your husband that you finally figured out what the issue is and how you can get back to all the things you love about your relationship.
Your husband’s reaction leaves you stunned and in shock.
Not only does he not recognize that there is a problem in the relationship, but he doesn’t want to talk about it.
That is his final answer!
You try everything you can to convince him, to try to get him to see what’s happening, to let him know how much you love him.
You are met with anger, denial, and the worst of all,
Silence…
You have too much invested in this relationship to give up. You have to make him understand.
As the conversation escalates past the point of no return, you risk facing the possibility of separation or worse yet divorce.
What happens after that will leave a trail of financial ruin, separation from the man you love, and the unintended harm to your children who are left confused, hurt, and wondering if it’s their fault.
There is really only one choice…
I Have To Convince My Husband To Get Help!
This may seem like mission impossible, but once you understand why he’s acting so unpredictable and the barriers he faces to getting help, you can help him get out of denial and into counseling.
In my experience as a mental health counselor working with distressed couples, I find that men who are resistant to see a mental health counselor reluctantly schedule an appointment when one of two things happen.
Obvious Strategies That Will Destroy Your Marriage
Obvious Strategy #1 – The Ultimatum
You give him an ultimatum to go to counseling or you will take the children and leave.
Although this ultimatum may prod him to seek counseling, it could just as easily end with him leaving.
It is a roll of the dice and you have no say in the outcome.
This is the nuclear war option of convincing your husband to go to counseling.
Obvious Strategy #2 – The Time Bomb
Your husband’s symptoms of mental distress (anger, anxiety, depression, etc) have become so severe that it becomes impossible for him to ignore the reality of his symptoms any longer.
At this point, your husband has a panic attack or struggles controlling his emotions. The thought of bursting into tears at work or feeling like he is having a heart attack scares him into seeking help.
This puts you in a “wait and see” mode hoping that your husband recognizes what’s happening in his life before something catastrophic and irreversible happens. Your family is left in chaos and your future is uncertain.
The healthy path to helping your husband to get help falls between the two extremes of pushing the nuclear button or waiting for the bomb to go off.
3 Myths Men Believe About Counseling That Are Really True!
Convincing your husband to seek therapy begins with understanding why he is resistant to seeking out help with a therapist. It’s often not the case that he thinks therapy doesn’t work on men. He may not recognize that there is a legitimate need for him to go to therapy.
To help you understand better why he refuses to see a counselor I’ve outlined the three myths that men believe that prevent them from seeking out therapy.
Myth #1 – Real men don’t need therapy.
“Suck it up buttercup“
“Rub some dirt on it, you’ll be fine“
“There’s no crying allowed, stop being a whiny baby“
These are the messages that your husband grew up hearing time and again from all the important male role models in his life. He never thought to question whether they were true or not. That was just the way it was growing up.
He learned to be a man thru a process called Masculine Role Socialization.
Through his formative childhood years he was taught exactly how a “man“ is supposed to act, feel, and think. If he deviated from these expectations, even in a small way, the consequences were immediate and negative.
“Stop being a pansy“
“If you’re going to act like a whiny baby go see your mother“
“If you’re going to act like a little girl, go put on a dress“
Your husband’s emotions were seen as a negative, A weakness to be overcome through suppression and compartmentalization.
Men are logical, hard-working and tough, as opposed to women who are seen as emotional, incapable, and frail.
A father’s role is to toughen him up to face the world. A father is supposed to teach a son how to pull himself up by his bootstraps and become a self-made man.
Self-sufficiency, strength, and invulnerability are prized character traits.
A research study published in the American Journal of Men’s Health found that,
“Men seek help at half the rate of women has largely been attributed to the pervasive impact of masculine norms, which emphasize the importance of self-sufficiency, strength, and invulnerability.”
Your husband has grown up in that world and that is his reality. He doesn’t question it, he just accepts it and pushes forward.
The sad truth is that his beliefs are grounded in societal norms. If he admits failure in himself or his marriage he accepts that he is a failure.
Seeking therapy is a radical shift for your husband that goes against everything he has been taught by almost every male role model in his life.
Myth #2 – What’s happening in my life is not a big deal
You know your husband better than anyone else in his life and when you see stress, anxiety, and depression affecting his daily life you naturally reach out to him and urge him to get help.
Do you astonishment he lies anything at all is happening and claims that everything is just fine. You see the pain and hurt in his eyes. You deal with the angry outburst, moodiness, and constant withdrawal.
Why can’t he see what’s going on when it is so obvious to everyone around him?
Your husband’s symptoms of distress are viewed as just character traits every normal man. The same study from the American Journal of Men’s Health also found that…
“Male-typical depressive symptoms can include aggression, irritability, violence, substance abuse, risky behavior, or somatic complaints—none of which are included in the current Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis criteria for Major Depressive Disorder (MDD).”
This research study presented the impact that having male typical symptoms of depression have on men seeking treatment using the graph below which depicts the relationship between traditional and male-typical symptoms that men experience and the probability that they will seek treatment.
If your husband is experiencing male-typical symptoms the chance of him seeking treatment may be low.
Many of these male-typical symptoms are actually ritualized in sports such as football, boxing, and mixed martial arts. Celebrations of victory may include other symptoms such as substance abuse and risky behavior.
To your husband these are just normal activities that all men participate in and have no bearing on his mental health. In fact, he may actually claim that these activities help reduce his stress.
Worse yet, he may be unable to show sadness or other traditional symptoms of mental disorders. The research study as mentioned above stated,
“Male-typical issues, such as masculine norms and alexithymia, may limit men’s ability to express sadness or other traditional symptoms of depression. As a result, men may underreport their depressive feelings and forgo treatment.”
Your husband may not be ignoring or overlooking his symptoms, but may actually be unable to recognize certain emotions in himself.
He has grown up in a world where there is little or no connection between how he feels and language he needs to describe emotions. This leaves him stuck in a spiraling loop of ever increasing distress well being unable to recognize that he is in distress.
Myth #3 – If I really had a problem my doctor would have told me
When you finally get him to go see his primary care doctor, you may be shocked when he returns to say that the doctor told him everything was fine.
Even if you go to the appointment with him and describe the symptoms you were seen it still may not be enough to convince his physician to recommend counseling. A separate study by the American Journal of Men’s Health revealed that,
“Underdiagnosis of mental health issues, like depression, in men may be the result of differences in how men and women manifest symptoms. Various factors, including gender socialization, lead many men to exhibit depressive feelings through male-typical depressive symptoms.”
The symptoms you see in your husband that you accurately describe to the doctor may not fit into the typical symptoms for a particular mental health disorder.
With no clear-cut recommendation from your husband’s doctor, your husband will leave the doctors office visit feeling vindicated.
“See honey, I told you everything was fine!” he says to you as you both walk out to the car.
If you feel like you are a broken record and nobody is listening, don’t give up.
You don’t have to revert to the nuclear option of an ultimatum or except defeat and wait for the explosion.
Below is a step-by-step guide to overcoming the male myths toward counseling and getting back the man you love.
3 strategies to breaking down the barriers for men seeking counseling
A full frontal attack on your husband‘s view of mental health will only result in a counterattack or a hasty retreat. Breaking down these barriers requires a soft touch and a strong show of support that he will never expect.
Implementing these steps will require a certain amount of finesse and an absolute absence of anger and sarcasm.
Many of the steps may be seen as common sense, but don’t be fooled into underestimating their power. Their true strength in breaking down barriers lies and not just what you do but how you do it.
Above all, you will want him to see you as being on his side and not on the opposing team. Throughout this process is important that he believes you have his best interest in mind.
Strategy #1 – Be his ally, not as opponent
If you want your husband to change the first step is to position yourself as someone who is on his side.
This may seem like a no brainer, since you are already 100% on his side, it requires more than you being on his side, it requires you to convince him that you’re on his side.
Dr. John Gottman, world renowned couples researcher and author of the book The Seven Principles For Making Marriage Work, says,
“People can change only if they feel that they are basically liked and accepted the way they are. When people feel criticized, disliked, and unappreciated they are unable to change. Instead they feel under siege and digging to protect themselves.“
If you feel like accepting your husband for the way he is will doom you to a marriage that will never change, you are not alone. It seems counterintuitive to accept him as he is to encourage him to change. But I see this work time and time again in marriage counseling.
When your husband knows that you love and accept him for who he is at his core, he will be more open to listening to your opinions and suggestions.
Now that he is opening up, he needs to know that you can keep his secret.
Confidentiality is the key to him feeling safe.
The prevalence of the myths above, make confidentiality essential to the change process. Disclosing what your husband is going through and emotions he is having to people outside of your relationship will be seen as a betrayal of his trust in you.
A potential pitfall to avoid is comparing him to other men as a way of showing him he needs to change. The message that he receives is that he’s not good enough for you and not enough of a man to deserve you.
His belief may not make any sense to you, because that is not how you feel. It is definitely not the message that you’re trying to send to your husband, but he won’t see it that way.
In summary, becoming your husband’s ally involves accepting him for who he is, maintaining his confidentiality, and avoiding comparisons to other men.
Strategy #2 – Help him translate his feelings and emotions
As you already know, many men have difficulty translating their feelings into words.
His inability to translate his emotions into word is not his fault.
Ronald F Lavant, former American Psychological Association president, coined the term, ”Normative Male Alexithymia” to describe the difficulty your husband has in translating his emotions into words.
What that clinical term means for you is that your husband grew up being told by society to follow a traditional masculine role which produced masculine identity conflicts with many of the emotions that he felt, but is not allowed to express.
Your husband has emotions, but is not allowed to express emotions.
To resolve this conflicts your husband needs your help to translate what he is feeling on the inside into words. This will not be an easy process for him
Identifying new previously emotions is like learning a foreign language.
Just like learning any foreign language, the key to mastery is starting with the basics. You can start by helping him identify the six basic emotions as identified by Paul Ekman, the American psychologist who pioneered the study of emotions. These basic emotions are:
- Anger
- Disgust
- Fear
- Happiness
- Sadness
- Surprise
As your husband is puts his emotions into words, it is time to take the next step and seek help from a professional your husband trusts.
Strategy #3 – Enlist other professionals to encourage your husband to seek treatment that caters to him
I can hear you saying at this point, “Eric, you just told me that medical providers often under diagnose men with mental health concerns,” and you are absolutely correct.
As a result of your husbands newly developed ability to identify and express emotions, he is now able to explain how he is feeling to his primary care provider or other trusted professional.
The key to successfully in this stop is leveraging someone that your husband will respect to give him sound advice. I’m not talking about a family member or best friend, but a trained medical or mental health provider.
Offer to go with your husband to his appointment as an ally for support.
You are not there to set the record straight and make sure he tells the doctor everything correctly.
That mindset would set you up as the evaluator of his performance and would not an ally.
If your husband is wary of you coming to the appointment with him, be ready to establish some ground rules to increase his comfort.
Possible rules that you could put in place are:
- it’s up to you what we talk about at the appointment and I won’t bring up topics you say are off-limits.
- If you feel uncomfortable with me in the room, I’m happy to leave and give you space.
- If you need time after the appointment to think about what the doctor said before we discuss it, just let me know when you’re ready to talk.
The more explicit and predictable his appointment appears to be, the more comfortable he will be with going to the appointment.
Once the doctor or other mental health professional identifies areas of concern and refers your husband for counseling it is important that you are prepared to assist your husband in finding the right therapist.
Your husband needs a counselor specifically trained to meet his needs.
You can ask your doctor for a referral to a specific counselor or you can do your own search.
The counselor that your cousin went to or the friend of a friend will probably not be a good fit for your husband.
Everything about the new counselor needs to put your husband at ease and inspire confidence.
Nothing is worse for him than showing up for his first counseling appointment and having to sit on a pink frilly couch and watch an episode of Dr. Phil with three other women in the waiting area.
Whether you get a referral or not, you need to research the counselor to ensure a good fit for your husband.
So what are you looking for in the ideal counselor?
In the book, Negotiating the Therapeutic Alliance: A Relational Treatment Guide, written by Christina E. Newhill, Jeremy D. Safran, and J. Christopher Muran, they report that,
“After nearly half a century of psychotherapy research, One of the most consistent findings is that the quality of the therapeutic alliance is the most robust predictor of treatment success“
What is therapeutic alliance?
The therapeutic alliance is the bond between the counselor and your husband.
A study published by the Butler Center for Research identified four factors that predict the outcome of treatment.
As you can see in the diagram above, the client-therapist relationship contributes 30% to patient treatment outcomes.
This same study identified empathy and expertise of the counselor as the two most important factors in building a therapeutic alliance.
In a study published in the British Journal of Psychiatry titled, Gender differences in preferences for psychological treatment, coping strategies, and triggers to help‐seeking, men are more likely to seek therapy if the therapist caters to men and takes into account who they are as men.
The bottom line is that your husband must feel comfortable with his therapist to have the best outcomes.
Take action today to help your husband
Keep in mind the messages that he grew up believing. It is not his fault that he was taught to believe that he had to be tough, ignore his emotions, and minimize distress in his life.
You can support him best by being his ally, helping him translate his emotions into words, and encouraging him to reach out to a professional.
Commit to sitting down with your husband today and having a loving, judgement-free conversation.
Share with him what he means to you and how much you love him.
Ask him how you can support him and be his ally.
He is worth the effort and so are you!
I want to share with you one of my favorite quotes:
“A perfect marriage is just two imperfect people who refuse to give up on each other.” – Unknown
I believe in you, your husband, and your marriage.
Best Wishes,
Eric Beasley, MA, LPC, NCC
