Man, are you in a funk; Depression: Males have it really bad but won't admit it, therapist says.


Terrence Real, a Boston-area social worker, is the hot new thinker about troubled men, the counterpoint to Carol Gilligan's decade-long feminist research project on adolescent girls.

He makes no bones about how he qualifies for the job: "I am the son of a raging, covertly depressed father, who was the son of a raging, covertly depressed father, who was the son. ... I have two boys, Justin, 12, and Alexander, 9, and they will not say that."

It took 20 years for Real to get his father to talk. In a daylong talk at the University of Maryland School of Social Work in Baltimore recently, Real told parts of his story and those of his patients at the Family Institute of the Cambridge (Mass.) Gender Research Project.

He believes men today are depressed in epic proportions. But being men, they don't tell anyone.

They cover it up: They work too many hours. They watch TV, surf the Internet, brag, talk nasty, philander, beat their wives. They drink, eat, insist on sex, and win, win, win, on the theory that they are only as good as their last game, their last merger. They become millionaires. Anything to escape intimacy.

Thus do men protect themselves from feeling depressed.

But not, it seems, from being depressed. In his best-selling book, "I Don't Want to Talk About it: Overcoming the Secret Legacy of Male Depression," he guesses men are at least as depressed as women, despite numbers showing that women suffer from depression at rates two to four times higher than men and the notion, wrong, that depression is a woman's disease.

"Pain men do not deal with; they tend to inflict," Real says.

The psychotherapist establishment doesn't readily buy Real's expanded definition of depression, in which men can be found covertly depressed who drown their feelings in obnoxious, obsessive and often hurtful actions. Being a jerk is not depression, they counter. But some of his theory is not new; just better told, and a host of new titles -- including the new Susan Faludi book, "Stiffed," and therapist Michael Gurian's "The Good Son" -- offer similar perspectives.

Real attracted 200 professionals in his September talk. "There's nobody in Maryland doing what he's doing," said Helene C. Dubov, a Rockville couples therapist who amiably played the role of a man named "Joe" for the day so Real could demonstrate his technique.

Real's methods are gleaned from his two decades as a family and couples therapist. His clients range from blue-collar and poor Irish in Boston to wealthy Harvard-educated businessmen.

His language is crude, his manner blunt; always he lays out his cards. He assumes everybody's got a cover-up and tries to find it -- one successful lawyer spent the weekend eating in front of the TV -- and once he uncovers the covert depression, he tries to get them to walk back through the fire, to feel the pain, to find out what in boyhood sets up the depression -- often by first telling them his own story.

"What kind of father did you have?"

"What kind of father do you want to be? What kind of emotional legacy do you want to pass on?"

"It's practical," said Pete Musser, a Howard County therapist who treats abusive men in an effort to reduce domestic violence. "A lot of it is giving these guys some empathy and listening to, hearing their side."

Real says the problem with these men is that they are hollow, as described by T.S. Eliot:

Remember us, -- if at all -- not as lost

Violent souls, but only

As the hollow men

The stuffed men.

Men become hollow, he says, because the culture "turns" boys into men by trying to disconnect them first from their feelings and then from their mothers. The socialization process for boys, Real says, amounts to disconnecting them from feeling and replacing it with violence. (Girls, on the other hand, are taught to value themselves through their connection to others.) Being a man means accepting psychological neglect or trauma. The stuffing is grandiosity.

Given this, why would any man admit depression, "when the very definition of manhood is standing up to discomfort and pain?" Real asks. Thus, the cover-up. Real argues that the culture allows this; even therapists don't want to shame a guy by labeling him as depressed.

The first and most common question in the Baltimore audience is how they, mostly female therapists, can get a man to come in for therapy in the first place.

The answer from Real is that the way to empower men is to empower women. They are the ones who usually initiate therapy sessions for their husbands or loved ones. Men might not want to do the work, but they do it for the sake of their children or in the hope of saving their marriage; it's leverage, Real says.

"Men are not uncomfortable with things the way they are," he says. "Women have changed, and men haven't," he says. "The work is just beginning with boys and men."

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