8 things men *actually* talk about in therapy when it comes to relationships

Since joining our Well+Good Council, Drew Ramsey, MD, has become our man on the inside (so to speak)—as a psychiatrist and mental health expert, he’s offering up some *major* insight into what makes people tick. Today, we’re picking his, er, brain about the most common topics that come up with his male patients when it comes to relationships. Read on for some illuminating intel—AKA real talk about man talk. 

Here’s a little trivia: Before co-founding Well+Good, Melisse Gelula was on track to be a psychoanalyst. She likes to ask what’s happening in my office. Ya know. “Man stuff.”

That’s right. There are men on my couch. They’re talking about their feelings. This might surprise you (or not so much). Men are just as emotionally sensitive and moody as, well, everyone else.

So what do real, live men actually talk about in psychotherapy? Here are a few of my favorites topics in a good bro-session.

1. How to say it—AKA communicate with their partner positively

I wager this is the number-one man problem on my couch. Good intentions. Bad words.

2. The pressure they feel to solve problems

Years ago when I was a baby shrink, I was treating a woman in her 40s for depression. As my brain was cramping trying to see some light in the a very bleak picture, she stopped me, “Stop being such a man! You’re trying too hard to fix things.” It was good counsel. Men don’t like unresolved issues in relationships. We quickly become “fixers,” but that often makes us crappy listeners. Your man will settle down and be much more helpful if you ask him for what you really need: Don’t fix. Listen.

3. The things they usually keep locked away

Some sessions with men are a master class in wall building. Tall. Strong. Fortified. Drone patrolled. When men let me slip past the wall, I’m often struck by the sweetness and richness they keep deep in their past, their struggle to be cool in seventh grade, the bigness of their ambitions and fears.

4. Their desire to (sometimes) be put to work

The most secure men I see have clarity about their utility. I joke with my wife when there’s something I need to fix or carry, “Time to bring in the ManTool!” And I love this service, be it opening a jar or carrying 14 bags of groceries home from Whole Foods. It’s my usefulness as a man that helps me feel secure.

5. Sex and orgasms

No pressure! Okay, so first let’s put out the disclaimer that this is changing in the mashup of modern love, feminism, and Tinder. Men are often unsure what to do with a healthy libido and sometimes feel really secretive and embarrassed about their sex drive. They worry the sex on the internet is real. Some mysteries about you and your sexual desires are a frequent topic. I tell them to take it slow and not to equate “sex” with intercourse. But I bet you have much better advice for your partner. Tell him.

6. Depression

The statistics say the rate of depression is twice as high in women. I’m not convinced. Depression presents differently in men—they may not be as tearful or “sad,” but rather shut down, irritable, and short-tempered. They lose interest in socializing and ambitions turn to a list of annoyances. Often when men are depressed, they refuse to consider sharing it: “Why would I let anyone see this part of me?” People tend to handle mental illness like cancer: They don’t know what to say. Be curious. Listen. Lead with love.

7. Their angst about dating

I might get thrown out of my man club and secret therapist societies, but it’s true. “Playing the field,” “dating around,” “not looking for something serious”—that’s all BS. Every man wants something serious. A partner that’ll love them, guide them, tolerate them, and better them. Most men “dating around” look at me sheepishly when they’re seeing multiple women at once. They thought they were living the dream, but between the fear of mixing up names and the anxiety that someone is getting attached, it’s not as much fun as they thought.

8. Their desire to “be a man”

So. Hard. To. Say. Masculinity is wrapped up with so much baggage—but at our core, being a man means being needed as a man. I was recently feeling super manly, not in front of my grill or hustling on the court with the fellas. Nope. I was in a minivan. Driving home, my wife and kids all nodded off. My brood. The road stretched out in front of us, and as I told my shrink a few days later, I felt deep contentment of manhood.

As a psychiatrist and farmer, Dr. Drew Ramsey specializes in exploring the connection between food and brain health (i.e. how eating a nutrient-rich diet can balance moods, sharpen brain function, and improve mental health). When he’s not out in his fields growing his beloved brassica—you can read all about his love affair with the superfood in his book 50 Shades of Kale—or treating patients through his private practice in New York City, Dr. Ramsey is an assistant clinical professor of psychiatry at Columbia University College of Physicians and Surgeons.

What should Drew write about next? Send your questions and suggestions to [email protected].