I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression

by Terrence Real Narrated by Adam Verner

Overview

Each year, millions of men and women fall prey to depression. While the disorder has been called "psychiatry's most treatable condition," less than one in five get help. In recent years, the silence surrounding depression in women has begun to lift, but only now, with this powerful groundbreaking work, does psychotherapist Terrence Real expose a virtual epidemic of the disorder in men.

Twenty years of experience treating men and their families has convinced Real that there are two forms of depression: "overt" and "covert." Feeling the stigma of depression's "unmanliness," many men hide
their condition not only from family and friends but even from
themselves. Attempts to escape depression fuel many of the problems we think of as typically male-difficulty with intimacy, workaholism,
alcoholism, abusive behavior, and rage. By directing their pain outward, depressed men hurt the people they love, and, most tragically, pass their condition on to their children.

A master storyteller, Real mixes penetrating analysis with poignant, compelling tales of the men and women whom he treats. He writes with passion and searing clarity about his own experiences with depression, as the son of a depressed, violent father, and the father of two young sons.

Peggy Papp of the Ackerman Family Institute calls this book "a pathway out of the darkness." Real teaches us how men can unearth their pain, heal themselves, restore relationships, and break the legacy of abuse. I Don't Want to Talk About It
offers great wisdom, hope, and practical guidance to men and their families. This is one of the most important and straightforward books ever written about men.

Editorial Reviews

Publishers Weekly - Publisher's Weekly

Hidden male depression is the focus of this clear, compelling book by a Massachusetts family psychotherapist who specializes in working with dysfunctional men. Because our culture socializes boys to mask feelings of vulnerability, he says, they bury deep within themselves damaging childhood trauma and its ensuing depressive effects when they become men. This strongly reasoned study starts out with an illustration of the "toxic legacy" that is passed, often for generations, from father to son, with each chapter adding another piece to the complex face. The lucid exposition of ideas is made more vivid through dramatizing. Real uses "composite" cases, so no actual person is depicted except the author himself. One of the most arresting aspects of the book is the autobiographical thread that he weaves throughout. Real's central concern is what he calls covert depression, a pain-filled, inchoate state that may or may not eventually erupt into overt depression. The book is wise beyond its stated scope: in setting up a model for the nature, etiology and treatment of male depression, Real ends up offering-with some gender variants-an almost universal paradigm. BOMC, QPB and One Spirit alternates. (Jan.)

Library Journal

Real, a psychologist with 20 years of experience treating men and their families, begins with a poignant scene of his father starting to open up and share the pain of his life. From there, Real unravels the buried feelings men have and how these feelings can lead to estrangement from self and family. The wounded boy grows to be a wounding man, inflicting on those closest to him the very distresses he refuses to acknowledge in himself. Real discusses the relation of depression to addictive behaviors, not only drug or alcohol abuse but also workaholism, gambling, and other compulsions. The cure is in confronting the addictive defenses and allowing the hidden pain to emerge. Throughout, Real gives examples of men who discover cruel, shocking traumas from childhood and their adult depression by undergoing guided imagery, talking in a group of similarly depressed men, or discussing the trauma in family counseling. Highly recommended for both public and academic libraries as well as professional counseling collections.-Susan E. Burdick, MLS, Reading, Pa.

Kirkus Reviews

An absorbing and informative look at the hidden long-term depression that constricts or undermines the relationships of many American men.

Real, a family therapist and teacher at the Cambridge (Mass.) Family Institute, contends that most male depression is undiagnosed because it is veiled by addictive and compulsive behavior using such varied "drugs" as alcohol, work, violence, and sex. Its key symptom is "relational immaturity," an inability or unwillingness to truly confide in and be vulnerable before a partner or child. Real traces this problem in part to the gender-polarized socialization of American children. From an early age, boys are encouraged to seek esteem through "hierarchical competition" while being discouraged from expressing feelings and bonding with others. In addition, boys sometimes "carry" the depression suffered by their fathers and expressed through emotional abuse or neglect. Much of Real's argument has been made by other clinical and popular psychologists, but he states his case particularly vividly, drawing richly on his own family history, his clinical practice, myth and legend, film and fiction. He also offers advice and case studies on how the therapist might resolve depression by helping patients overcome their fear of intimacy and redefine their notion of success. He also recounts active therapeutic interventions to stop the kind of toxic family dynamics that a husband's depression can help generate. On the downside, Real overfocuses on the father-son relationship; there is too little here on how depressed or narcissistic mothers may contribute to long-term male depression, much less on how siblings or societal factors may do so. Stylistically, it is somewhat marred by repetition, and the occasional use of a clumsy phrase ("rageaholism") or hyperbolic generalization, such as a reference to "the state of alienation we call manhood."

Fortunately, such lapses are a minor part of what otherwise is an important and rewarding work.

From the Publisher

This is a hopeful and important book because it shows a way out of depression for men.” —The New York Times Book Review

“An important book about men and depression that is uplifting...Men will recognize the other men found here: laconic bullet-biters, 'rage-aholics,' emotional runaways, and badly fathered sons turned into disconnected dads who spill their emotional truths onto the page.” —Richard Higgins, The Boston Globe

“Extraordinary...brings to light a hidden history of male depression...A powerful book.” —Michael Kimmel, San Francisco Chronicle Book Review

“The most provocative in a flood of new books on depression...The only volume that speaks exclusively to and about depressed men.” —Pamela Warrick, Los Angeles Times

“Offers not only crucial insights to men suffering from depression but also comfort and guidance to the women who love them.” —John Bradshaw

“This is a sobering, powerful book about male depression both ‘covert’ and ‘overt.’ The book moves on to new ground both in language and story. I Don’t Want to Talk About It is exhilarating in its honesty and grief; it moves forward like a hurricane.” —Robert Bly

“Even in this era of managed care and Prozac, therapy is still an art. Mr. Real emerges in this book as an artist who plays his theories with the passion and skill of Isaac Stern in concert.” —Dallas Morning News

“A tour-de-force, this landmark book uncovers a hidden epidemic with devastating effects. In an elegant novelist style, Terrence Real traces the shadow of male depression from father to son. And in a bold, courageous way, he tells his own story of trauma and recovery, which shines like a golden thread throughout the book.” —Connie Zweig, Ph.D., author of Romancing the Shadow

“Riveting reading. You pick it up and can't put it down. . . . I Don't Want to Talk About It could get you started on a conversation with yourself that would allow you to shed a burden you've been carrying a long time." —Jane Tompkins, The Raleigh News & Observer

“Terry Real writes with understanding and compassion for his own father, for himself as a father of young sons, and for the many men in his practice whose stories he tells. Like a good novel, I Don’t Want to Talk About It pulls you in and keeps you reading. Beautifully written; it’s an important book for all of us.” —Olga Silverstein, author of The Courage to Raise Good Men

“Boys in our culture are taught that real men are stoic. The ability to not complain, endure pain, and strive in the face of adversity is admired and celebrated in story and song. The price paid for this isolation is depression. Terry Real has produced a seminal work that is likely to be the text of choice for therapists and patients for many years.” —Pia Mellody, author of Facing Love Addiction and Facing Co-Dependence

“Clear, compelling . . . strongly reasoned. . . . The book is wise beyond its stated scope: in setting up a model, nature, and etiology and treatment of male depression, Real ends up offering—with some gender variants—an almost universal paradigm.” —Publishers Weekly

Product Details

BN ID:	2940170440153
Publisher:	Tantor Audio
Publication date:	12/05/2011
Edition description:	Unabridged
Sales rank:	757,003

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

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