Read an Excerpt
From Chapter One: Men's Hidden Depression
When I stand beside troubled fathers and sons I am often flooded with a sense of recognition, All men are sons and, whether they know it or not, most sons are loyal. To me, my father presented a confusing jumble of brutality and pathos. As a boy, I drank into my character a dark, jagged, emptiness that haunted me for close to thirty years. As other fathers have done to their sons, my father-through the look in his eyes, the tone of his voice, the quality Of his touch-passed the depression he did not know he had on to me, just as surely as his father had passed it on to him — a chain of pain, linking parent to child across generations, a toxic legacy.
In hindsight, it is clear to me that, among other reasons, I became a therapist so I could cultivate the skills I needed to heal my own father — to heal him at least sufficiently to get him to talk to me. I needed to know about his life to help understand his brutality and lay my hatred of him to rest. At first I did this unconsciously, not out of any great love for him, but out of an instinct to save myself. I wanted the legacy to stop.
One might think that I would have brought to my work a particular sensitivity to issues of depression in men, but at first I did not. Despite my hard-won personal knowledge, years passed before I found the courage to invite my patients to embark upon the same journey I had taken. I was not prepared, by training or experience, to reach so deep into a man's inner pain — to hold and confront him there. Faced with men's hidden fragility, I had been tacitly schooled, like most therapists-indeed, like most people in our culture — to protect them. I had also been taught that depression was predominantly a woman's disease, that the rate of depression was somewhere between two to four times higher for women than it was for men. When I first began my clinical practice, I had faith in the simplicity of such figures, but twenty years of work with men and their families has lead me to believe that the real story concerning this disorder is far more complex.
There is a terrible collusion in our society, a cultural cover-up about depression in men.
One of the ironies about men's depression is that the very forces that help create it keep us from seeing it. Men are not supposed to be vulnerable. Pain is something we are to rise above. He who has been brought down by it will most likely see himself as shameful, and so, too, may his family and friends, even the mental health profession. Yet I believe it is this secret pain that lies at the heart of many of the difficulties in men's lives. Hidden depression drives several of the problems we think of as typically male: physical illness, alcohol and drug abuse, domestic violence, failures in intimacy, self-sabotage in careers.
We tend not to recognize depression in men because the disorder itself is seen as unmanly. Depression carries, to many, a double stain — the stigma of mental illness and also the stigma of "feminine" emotionality. Those in a relationship with a depressed man are themselves often faced with a painful dilemma. They can either confront his condition — which may further shame him — or else collude with him in minimizing it, a course that offers no hope for relief. Depression in men — a condition experienced as both shamefilled and shameful — goes largely unacknowledged and unrecognized both by the men who suffer and by those who surround them. And yet, the Impact of this hidden condition is enormous.
Copyright © 1997 by Terry Real
