Lingering in the Pain: On Men, Masculinity, and Depression

Dr. Yair Apter, a clinical social worker with over 25 years of experience, specializes in rehabilitating men who have expressed violent behavior. His journey began in a prison setting, where he uncovered the complexities of male psychology. As a professor of gender studies and director of the Naamat Fatherhood Center, he explores male depression, societal norms, and the need for gender-sensitive therapy. His work sheds light on how men externalize pain and resist vulnerability, advocating for emotional resilience and self-compassion.

(The details of the case described in this article have been modified to maintain patient confidentiality, and the patient has given consent for its publication.)

Moshe Wants to Die

“Do you have a 9mm bullet?” Moshe replied when I asked if there was anything I could help him with. The way he sat down in the clinic chair left no doubt about his mental state. He had difficulty sitting up, almost lying down on the chair, and showed no sign of wanting to talk. I poured him a glass of water and asked if he wanted me to bring him a footstool so he could rest his feet. Moshe refused. After drinking, he began to speak: “I barely managed to get here. I finished a meeting and wasn’t sure I could drive. I don’t have the strength anymore, I can’t keep going, I don’t intend to wait for surgery. I’d rather die. My family is taken care of. I’ve done enough. I’ve achieved everything I wanted. The children can live without me.”

Moshe, in his fifties, came back for treatment after a four-year break, much thinner and more emaciated than I remembered. Recently, his health had deteriorated, and in the coming year, he would have to undergo complex surgery. He contacted me after his girlfriend asked him to call when she realized he was refusing to undergo a medical procedure he needed due to his condition and that he would rather commit suicide. In the two previous rounds of therapy, I met with Moshe because of the depression that overwhelmed him due to unexpected life events. Depression was no stranger to him, but this time, it was unlike any previous episode. Moshe had lost over 20 pounds, he could not fall asleep but also had difficulty waking up, he was constantly cold, and according to him, he found himself sitting under hot water in the shower for over 20 minutes to warm up. Moshe was not eating, and all of his wife’s attempts to encourage him and ensure he ate were met with refusal. The illness he had and the need to undergo medical intervention were not, in themselves, the cause of his suicidal thoughts. Indeed, studies show that most suicide attempts or cases among those suffering from physical illnesses stem from depression that preceded the illness (Jamison, 2000). However, the connection between Moshe’s tendency toward depression and his physical condition worried me.

Moshe seemed to be overcome by gloom and despair. He spoke in a weak voice, and his body was exhausted. He had no desire to wake up, and it seemed that every action required great effort—talking, sitting, trying to concentrate, or answering my questions. I had never seen Moshe in such a difficult situation. I was afraid for him and felt helpless. This was the third meeting in this round, and the situation only deteriorated. In the first two meetings, we could still talk about the meaning of the surgery for him and consider together how I would help him cope with the emotional difficulties of dealing with the unknown. However, in this meeting, Moshe spoke only about his desire to die and his intention to end his life. Any attempt I made to inspire hope was rejected.

Moshe noted that he does not go to the doctor without his wife, Anat: “She talks to them, and they explain my condition and the possible solutions to her. I have no patience, and I cannot hear from the doctor that the pill will affect my blood sugar levels but has side effects regarding electrolytes. I am not built for vague answers. When a client comes to me, I do not confuse him or leave him uncertain—I am the expert. Although I am a manager and boss who holds my employees in high regard and in full control, when I sit with doctors, I feel small, vulnerable, and stressed. I am unable to cope with it.” Contact with mental pain aroused in Moshe feelings of helplessness, uncertainty, and anxiety, which were unbearable for him and did not allow him to linger in the pain. So the possibility of suicide was a viable solution for his emotional state. Many men demonstrate a need to remain in control, and one of the ways they often do this is by relying on a rational approach (Scher, 2006). In my experience, psychotherapy only begins when the rational explanations that patients give themselves about their condition crack and become ineffective—but it is precisely in these situations that many men feel disconnected and disoriented. For Moshe, thoughts of death provided a rational solution to the emotional chaos he was experiencing. He was busy searching for the “final solution” to his distress, but in reality, he experienced ambiguity and uncertainty.

In fact, I too tend to think rationally, and Moshe challenged my tendency to think in a problem-solving style when dealing with emotional distress. However, at this point, like him, I was unable to muster more optimistic solutions, and I realized that I was not on the right track. I realized that I had to linger with Moshe in the depression and the death wish, and not be frightened by the fact that the patient “feels” with an almost unbearable intensity. The weight of the depression was present in every word that came out of Moshe’s mouth, and it weighed heavily on me. It was difficult for me, but I felt obligated to stay with Moshe in his psychological death, to stay with Moshe’s emotional experience and my distress despite the difficulty.

I was not ready for this, but I gathered the understanding that I had to be with him in his suffering. The depression and physical suffering that Moshe experienced were unfamiliar to me, and therefore I felt distant from him. However, in some ways, I managed to feel close to him. I love life and am even engaged in personal and professional development, but I recently celebrated my 50th birthday—with all that that implies. Last summer, I underwent unsuccessful foot surgery, and I suffer from chronic pain that I am learning to live with. In addition, my two older children started university last year, and one left home. The sense of loss in relation to physical abilities that decline with age, together with the changes my family has been going through recently, brings me into contact with thoughts about being an aging person, about pain that has no cure, about my time growing shorter, and about the end of life. The issue of my death and how I will end my life preoccupies me. I have no suicidal thoughts, but I am not afraid of death either. My thoughts about pain and the transience of my life helped me understand Moshe’s desire to die.

Moshe spoke mainly about the unbearable feeling of helplessness he felt and the thought that his life had no meaning in his current state. “I don’t know when the surgery will be. I don’t know if it will be successful, and I certainly don’t intend to endure all these thoughts. I don’t understand the need to live in my condition. There is no reason to suffer at any cost. In my condition, it is better to die.” When I asked if he had thought about it, he said that he had a kit ready at home. “Why haven’t you used it yet?” I asked. According to him, if his wife had let him, he would have committed suicide by now, but because she threatened to commit suicide after him if he ended his life, he hesitates: “I don’t want to leave my children orphaned. I know they can live without me, it’s the nature of the world—parents go before their children. But my children are too young to live without parents. I think it’s unfair to leave them alone.”

I knew that Moshe defined himself as a “control addict,” so I had difficulty believing he was completely willing to give up his life. Although some cases in which men express thoughts of suicide and death indicate a real risk, most suicidal thoughts, while frightening and concerning, do not lead to an actual suicide attempt. In fact, suicide is the final point on a continuum of suicidal thoughts and behaviors, beginning with risky behaviors, escalating to different levels of suicidal ideation, and ending in attempts and actual suicide (Jamison, 2000). Accordingly, it seemed to me that, in his suicidal thoughts, Moshe wanted to live and die at the same time.

Men and Depression

According to data collected in 172 countries, over 800,000 people commit suicide each year worldwide, and researchers estimate that men commit suicide 3.5 times more often than women. In Israel, the number of suicides in 2012 was 480, of which 94 were women and 377 were men (WHO, 2014). It is commonly believed that there is a link between suicide and depression, but when examining depression rates from a gender perspective, it turns out that the number of women suffering from dysthymia and major depression is twice as high as the number of men (Reiger, 1991; Kessler et al., 2013), to the point that depression is sometimes referred to as a “women’s disorder” (Cochran, 2005)—a surprising statistic given the gap in suicide rates between men and women.

In an attempt to understand these disparities, one must turn their attention to another gender gap: compared to women, men are more frequently diagnosed with substance addiction, antisocial disorders, and narcissism—diagnoses that reflect emotional detachment and the external expression of mental pain and intrapersonal conflicts through destructive behaviors. Addiction may indeed lead to anxiety, antisocial behaviors, and depression, but in many cases, the relationship is the opposite: for many men addicted to psychoactive substances, addiction serves as a coping mechanism for depression, one that is neither recognized by the mental health system nor by the men themselves (Cochran & Rabinowitz, 2000).

Such a lack of recognition was found, for example, in a study that examined depression diagnosis rates among patients in an alcohol rehabilitation center. While the treatment team at the center identified 17% of male clients as suffering from major depression, when researchers used a gender-sensitive questionnaire to diagnose depression in men, they found that 39% of them actually suffered from depression (Zierau et al., 2002).

There is now growing evidence that men and women differ in the way they express depressive symptoms: women are more likely to internalize depressive symptoms, which align with the classic diagnostic criteria for depression, whereas men are more prone to externalize them, often through self-harm and destructive behaviors (Kilmartin, 2005).

For example, a comparative study found a stronger link between depression and symptoms such as restlessness, irritability, aggression, and antisocial behaviors among men diagnosed with depression compared to women (Moller-Leimkuhler, Bottlender, Straub, & Rutz, 2004).

The direct expression of emotions and mental state makes it easier to diagnose mood disorders and depression in women. In contrast, in men, depressive disorders are often hidden and frequently masked by behaviors that are considered socially acceptable for men (Cochran, 2005).

To explain these differences, one cannot ignore the societal messages that encourage emotional suppression in boys and men in Western culture. These messages teach them from childhood that vulnerability should be hidden behind the “mask of emotional toughness” (Real, 1997; Englar-Carlson, 2006; Levant, 1998; O’Neil, 2015).

With the growing recognition of the connection between gender and the expression of emotional distress, recent years have seen increased research interest in the relationship between men’s perception of their gender identity and depression.

For example, one study found that men who experienced depression described it as “not being a man”, and that emerging from the depressive phase allowed them to feel masculine again (Emslie et al., 2005).

Additionally, research has identified a link between gender role conflict and depression: the more stress men experience about conforming to traditional masculinity, the higher their likelihood of experiencing emotional distress and depression (O’Neil, 2015).

A review of previous studies also found that internalizing traditional masculine ideals places men at greater risk for depression—as well as at greater risk of expressing it in destructive ways (Addis, 2008).

Similarly, a qualitative study of 14 men with depression found that those who strongly adhered to rigid traditional masculinity values experienced:

• Anxiety about work performance

• Emotional detachment from others

• Avoidance of emotional expression

• Substance use

• Reluctance to seek professional help

• Viewing suicide as a way to regain control in light of their psychological distress (Heifner, 1997).

Another study found that men who highly valued traditional masculinity ideals, including the need for control, anti-femininity, achievement, emotional suppression, and homophobia, were more likely to exhibit externalized and somatic symptoms of depression than men who were less committed to traditional masculine ideologies (Magovcevic & Addis, 2008).

The accumulated data on the unique nature of depression in men helps explain why suicide rates are significantly higher among men than among women.

It is likely that, for many men suffering from depression, suicide appears to be a quick and accessible way to escape unbearable emotional pain and the overwhelming weight of their depression.

This difficulty is further intensified by men’s attitudes toward emotional expression, their reluctance to acknowledge their own vulnerability, their struggle to verbalize their distress, and, most importantly, their hesitation to seek professional help.

Practical Solutions to Emotional Situations: The Difficulty of Dwelling in Pain

Men’s difficulty in dwelling in their pain and their tendency to escape from pain and seek quick solutions have many consequences for both the men themselves and those around them. It is too short space here to fully describe the impact of this pattern on men’s mental lives and the great complexity it evokes, but we will attempt to outline it and delve into the developmental processes that shape it using Winnicott’s concepts and other theories.

Winnicott (1996) believed that “being,” or, as he called it, “Being,” is a universal developmental achievement that emerges in the “good enough” environment of maternal care. The “capacity for action,” or, as he called it, “Doing,” is possible when there is a solid foundation of the capacity for Being and refers to spontaneous and enjoyable action that expresses the authentic parts of the self. The ability to Do grows out of the ability to Be in a calm and safe environment. Although Winnicott believed that men possess the capacity to experience both of these modes (Winnicott, 1956), he noted, based on observations, that women are more comfortable existing in the state of Being and tend to express this more than men. In light of the above, it can be assumed that men’s need to “do” emotions stems, among other things, from their lack of skill in Being and their difficulty in pausing when they experience painful emotions.

It should also be noted that men, compared to women, find it more difficult to engage in emotional speech, and many of them suffer from “emotional threat” (Bergman, 1995). Men are more likely than women to prefer solving problems through action rather than by talking about them. This problem-solving pattern can be effective, as it is characterized by a willingness to confront difficulties, take risks to protect others, and work hard. However, this pattern is sometimes futile and problematic, as it may manifest in unnecessary risk-taking, difficulty relaxing, and destructive actions as a way of expressing emotions.

Men’s preference for Doing over Being is formed early in life. In this regard, it is important to distinguish between biological masculinity and masculinity as a social construct: masculinity is not an inherent part of physical development but rather a developmental milestone, acquired with great effort by boys. The process by which boys develop psychological autonomy and a solid masculine identity is a difficult one, largely due to the expectation that they will shed and separate themselves from entire parts of their psyche that are perceived as feminine, particularly their needs for dependency and emotional support (Real, 1997). The psychological structures characteristic of men in Western society develop in early childhood, during the pre-Oedipal stage of psychological separation (before the age of 3), against a backdrop of cultural messages that instill feelings of shame in relation to these traits. These psychological structures serve to guard and protect against experiences of vulnerability associated with dependency needs (Krugman, 1995), but they are expressed in varying degrees of narcissistic defenses, which involve the denial of vulnerable aspects of the self and hinder the integration of different parts of the psyche.

Additionally, during the Oedipal stage, the child is increasingly confronted with familial, social, and cultural imperatives to distance himself from the maternal connection and everything it represents and to move toward a connection with the father. Boys are compelled to develop psychological autonomy, which includes detachment from maternal support and from internalized maternal qualities. However, the transition from initial identification with the mother to identification with the father often leaves the child with a sense of vulnerability due to the loss of continuous, close, and protective relationships (Chodorow, 1989). According to Real (1997), the demand for separation from the mother and all that she represents—including care, nurturing, emotional containment, and empathy—is the primary and fundamental disruption in the adult lives of men. For many boys, this transition involves the premature loss of relationships characterized by emotional openness and relational skills, resulting in a “premature separation,” which leads to an early trauma (Pollack, 1992).

It is important to emphasize that the separation is not only from the concrete mother but also from the experience of mutual empathy and relational connectedness. The discontinuity and rupture of an empathetic relationship shape all future close relationships the child will have in both family and society. This dynamic ultimately affects the child’s relationship with his father as well—even though, as part of the Oedipal process, boys are expected to identify with their fathers.

As a result, many boys are left with deep and unresolved longings for dependency, coupled with narcissistic defenses against acknowledging these needs. This later leads them into profound conflicts regarding intimacy, sexuality, and emotional expression. The shame associated with expressing unmet needs further intensifies the conflict surrounding dependency; shame—sometimes accompanied by humiliation—is close to the surface and can easily arise in situations of emotional need. Ironically, when men do express their needs, they often feel even more vulnerable. The suppressed feelings of shame and humiliation are, in turn, transformed into action.

Thus, the social expectations internalized by men during their development lead, as noted, to an avoidance of emotional expression in words and a tendency toward action-based solutions in response to emotional distress (Krugman, 1995). While women’s social conditioning, as well as their ability and willingness to express emotions verbally, increase the likelihood that they will process and integrate their pain and suffering, men often seek solutions that translate into quick, impulsive actions aimed at immediately eradicating distress. Though these externalized solutions may offer temporary protection from confronting painful emotions, the shift to action makes it difficult for many men to recognize their “wounded self”—a dynamic that contributes to the unique experience of depression in men.

Gender-Sensitive Treatment of Depressed Men

The ability of men to externalize pain protects some of them from experiencing depression; however, as Real (1997) points out, it does not prevent them from being depressed. Externalizing depression through behaviors primarily allows them to detach from their feelings and emotions, avoid emotional flooding, and disconnect from people in their lives—and even from life itself. Early processes in boys’ psychological development leave them no room to dwell in a space of vulnerability and mental pain, leading many depressed men to resort to practical solutions for coping with emotional situations, including suicide.

Men who suffer from depression tend to hide it from those around them. The metaphor of the “mask” is used by many writers to describe how men conceal their authentic mental state behind defenses that maintain a facade of “everything is fine” (Real, 1997; Pollack, 1998, 2006; Lynch & Kilmartin, 1999). In the context of depression, Pollack writes: “Among men, depression will often be masked, and therefore neglected and untreated. Depression will usually be wrapped in narcissistic defenses, or what I call the ‘mask of masculinity’” (Pollack, 2005, p. 211).

Accordingly, a qualitative study of 45 men who had experienced depression found that many interviewees felt a strong need to mask their depression through compulsive and other problematic behaviors. Moreover, the men emphasized their need to act according to masculine norms, which included avoiding expressions of weakness, hiding emotional pain, and trying to appear strong in the eyes of others. In fact, they described the “mask” as aligning with their tendency to avoid dealing with depression and, therefore, not admitting it at all (Rochlan et al., 2010).

Due to this need to conceal depression, men have more difficulty than women in identifying their painful emotional state and defining it as depression (Rochlan et al., 2010). However, even when they do recognize their depression, they struggle to seek mental health support, and this is no coincidence: therapy, which involves emotional conversations about vulnerability and feelings, is at odds with the societal messages men receive in Western culture—messages that encourage stoicism and emotional toughness while discouraging emotional expression (Addis & Mahalik, 2003; Mahalik, Good, & Englar-Carlson, 2003; Rochlen, Blazina, & Raghunathan, 2002).

As a result, men who seek professional mental health support often do so only when they have already reached a crisis point (Scher, 1990). In many cases, men seek mental health services only after external encouragement or involvement from a close family member (Cusack, Deane, Wilson, & Ciarrochi, 2004).

In light of all this, it is clear that gender-sensitive treatment of men experiencing depression requires therapists to recognize the unique characteristics of male depression in its gendered context.

First, therapists must acknowledge the tendencies of men suffering from depression:

• Avoiding the expression of emotions such as sadness, helplessness, and hopelessness

• Failing to recognize their condition as depression

• Underestimating the impact of depression on their daily functioning

• Believing there are no effective ways to manage their emotional distress (Rochlan et al., 2010).

Therapists must help men develop self-empathy regarding their mental state and guide them toward recognizing and changing their avoidance patterns (Lynch & Kilmartin, 1999).

Professionals should also be aware of the resistance and discomfort that men may experience when asked to discuss their condition. Normalizing this difficulty and emphasizing the effectiveness of emotional expression in the healing process can help hesitant men open up and increase their motivation for change (Rochlan et al., 2010).

Additionally, while traditional masculine values—such as self-reliance, the expectation to demonstrate bravery, and the responsibility to provide for one’s family—can intensify depression and discourage seeking help, therapists can reframe these values as strengths to encourage engagement in treatment.

For example, a therapist can reinforce that seeking mental health support and overcoming the shame often associated with it is an act of courage (Rochlan et al., 2010).

It is especially important for therapists to address how masculinity is perceived in different cultural and societal contexts (Cochran, 2005).

When diagnosing depression in men, professionals must look beyond the official DSM diagnostic criteria and consider gendered aspects of depression, including latent depression that may be masked by another overt disorder.

Indeed, among men suffering from depression, there is a high incidence of dual diagnoses, including:

• Alcohol abuse

• Substance addiction

• Antisocial traits and narcissism

• Compulsive and violent behaviors

It is essential to examine the interplay between these externalized behaviors and depression—both how they contribute to the development of depression and how depression fuels these behaviors (ibid.).

Between Emotional Relief and an Expanded Capacity to Endure

Due to the classic symptoms of depression with which Moshe came to treatment, it was easy to diagnose his condition. This is unlike most of the men I meet in the clinic who suffer from depression. Their symptoms are typically characterized by emotional stoicism, the use of psychoactive substances (mainly marijuana), and aggressive behaviors, including self-destructive tendencies.

In Moshe’s case, my ongoing acquaintance with him did not allow him to hide behind the pretense that he was merely seeking treatment for a decision-making issue. His mental state, which was familiar to both of us from previous therapy rounds, left no doubt that he was experiencing depression. However, I had to confront his desire to rid himself of life itself, as his mental and physical condition left him feeling that his life had no value. He even asked me to speak with his wife, Anat, so that she would allow him to die.

I saw a crucial need to help Moshe find meaning in his life—one that he would be willing to accept. It was clear to me that Moshe needed a reason to live so that he could tolerate the uncertainty of his situation and endure his emotional pain. However, I still felt uncertain about what could serve as a foundation for Moshe to change his outlook.

The first challenge with Moshe was to help him develop self-empathy and accept his own vulnerability and limitations. Moshe judged himself harshly for his inability to control his health condition, yet he was unaware of his emotional difficulty in coping with vulnerability and a lack of control. I realized that his inability to acknowledge this struggle was preventing him from finding meaning in his emotional pain. I needed to confront him with his difficulty in accepting his vulnerable state so that I could help him face his condition with empathy rather than self-judgment.

Additionally, because of Moshe’s deep love for his wife, Anat, and his strong sense of responsibility toward his family, I believed that the best way to shift the balance between life and death was to emphasize his responsibility for the well-being of the people who love him and need him.

After several therapy sessions in which I felt no progress was being made, I accepted Moshe’s offer and suggested that Anat join us for the next session. Moshe agreed: “She knows everything. I share all my thoughts with her, and if you think it will help—I’ll talk to her.”

Moshe hoped the session would help Anat accept his desire to die, but I had a different goal: I needed Anat’s presence because I was deeply worried about Moshe—even fearing that he might attempt suicide—and I could not rely on him to ensure his own safety.

I also suspected that his antidepressant dosage needed to be adjusted, and Anat’s involvement would guarantee proper psychiatric follow-up. Furthermore, I wanted to determine whether Anat’s claims that she intended to commit suicide if Moshe ended his life were serious.

At this stage of treatment, it was difficult for me to handle Moshe’s condition alone, and I needed another person to help carry the emotional burden of his depression. I hoped that Anat could serve as a stabilizing force to help Moshe break free from the emotional turmoil he had sunk into.

And indeed, Anat’s powerful presence made a difference and helped shift the balance.

Although my one-on-one sessions with Moshe had also been emotionally intense, during the session with Anat, Moshe shed a tear for the first time.

Every attempt he made to justify his desire to die was met with an assertive response from Anat, who firmly refused to accept the despair he projected.

Anat demanded that Moshe fight his depression and suicidal thoughts, reminding him that they had a long life ahead of them to live together.

Holding his hand, she insisted that he live—for her and for their children—and declared that she refused to give up on him.

She also promised to support him in any way necessary, even offering to visit his doctors alone if that would help.

Finally, Moshe promised to try to live.

Following this session, several more meetings were held with Anat present—at Moshe’s request.

Although he struggled to explain why her presence in therapy was so important to him, I felt that his request reflected his difficulty in expressing himself throughout the therapy sessions.

At the same time, it also demonstrated his deep need for Anat to be a source of emotional support and vitality amid the depressive whirlwind that had consumed him.

Where Moshe Stands Today

Today, I meet with Moshe without Anat’s presence. His mood has improved, and he is both thrilled and embarrassed by the dramatic change he has experienced.

His appetite has returned, his weakness and fatigue have diminished, and he has resumed full function at work.

Recently, Moshe and Anat even took a short vacation to a place they both love.

Given his current progress, the question arises: Should therapy end?

On the surface, Moshe seems less in need of help due to his improved mental state, but his physical health remains unchanged.

Furthermore, his ability to cope with the uncertainties of his medical condition and accept it as part of his reality has not evolved significantly.

While his mood suggests that he has made progress in coping with the despair he once felt, his views on death and suicide as solutions to suffering have not changed.

These persistent attitudes continue to concern me, and I want to be there for him in future moments of uncertainty.

It is well-documented that male patients who experience improvement in their mental state tend to drop out of treatment, and there is a high risk of relapse, in which depressive symptoms may return (Kilmartin, 2005).

Therefore, my next task in therapy with Moshe will be to help him fully understand the meaning of ending treatment—and to ensure that he does not leave therapy prematurely.

Summary and Conclusions

Moshe confronts his depression head-on.

As his therapist, my primary goal has been to expand his capacity to endure emotional pain and dissuade him from seeing suicide as the only solution to his suffering.

Indeed, in this article, I have emphasized not only the need to recognize depression in men but also the importance of helping them develop the ability to tolerate and process their pain and despair.

The way in which men’s gender identity is shaped, along with the degree to which they internalize traditional masculinity ideals, directly influences the characteristics of male depression—as well as the tools that can be used to treat it effectively.

In working with men suffering from depression, therapists must incorporate gender-sensitive interventions that take into account the unique ways in which depression manifests in men.

It is crucial that therapists understand the psychological development of men so they can identify the barriers that make emotional change difficult—thus fostering a closer, more empathetic, and more effective therapeutic environment.

One of the greatest challenges for therapists working with men is expressing empathy for their patients’ struggle to be empathetic toward themselves and their fear of expressing emotional neediness.

If therapists pressure men too early in treatment to admit their struggles, they risk triggering narcissistic defenses tied to values of “independence” and the belief that “I don’t need help”—which may result in men withdrawing from therapy or abandoning it altogether (Pollack, 2005).

Thus, therapists must balance two roles:

1. Being patient with men’s resistance to emotional vulnerability and communication

2. Encouraging them to develop emotional awareness and self-compassion

Through Moshe’s case, we can better understand how men cope with psychological distress and the role that gender norms play in shaping their emotional experiences.

Sources

Jamison, K. J. (2000). The Night is Falling Quickly: Understanding Suicide. Matar Publishing.

Winnicott, D. (1956). Primary Maternal Investment. In Winnicott, D. W., True Self, False Self. Tel Aviv: Am Oved, 2009.

Winnicott, D. W. (1996) Play and Reality, Tel Aviv: Am Oved Publishing.

Mitchell, S.A. (1993). Hope and Fear in Psychoanalysis. Bookworm Publishing.

Rill, T. (1997) I Don't Want to Talk About It: The Hidden Legacy of Male Depression—and How to Break Free from It. Am Oved Publishing.

Understanding Male Depression: Dr. Yair Apter on Masculinity, Mental Health, and Therapy Solutions