What Actually Happens in Men’s Therapy?

The first time I sought personal therapy, I went onto Counselling Directory and started scrolling. I wasn’t too sure what I should be looking for. 

A friendly face? 

Tons of qualifications? 

At some point, I sighed, logged off and thought ‘look, you’ve gotta work this out yourself’. Except all the trying in the world was getting me nowhere - if anything, I was digging myself a deeper, darker hole.

Questions & platitudes that held me back from making a decision.

What would I even say?

I’ll just learn to deal with it.

It’s not actually that bad.

Well, turns out it was. 

You’ve probably been in this position, too. Opened a tab, maybe typed something into Google, read the first paragraph of someone’s website, and closed it. Told yourself you’d come back to it. 

Didn’t.

But you’re back, looking again. There’s a feeling you can’t quite name, a relationship that’s hanging by a thread, a version of yourself you don’t fully recognise. And you’re keeping the tab open this time, though you still wonder “what’s this going to be like?”.

This post is for you. Here’s what actually happens in therapy.

So What Is Therapy, Exactly?

Only 36% of people referred to NHS talking therapies are men. The services exist. Men just aren't using them.

Suck it up. That’s life. Be a man.

I’m certain you’ve got your own personal mantra tattooed into your mind. In some way, shape or form, you’ve probably been trained to accept that help is not coming and you need to sort shit out on your own. Except you’re running out of “it is what it is” to push you through the next roadblock.

The idea of therapy makes you wary. Am I going to have to confess all my sins? Describe every vivid detail of my childhood to a stranger and then get a label slapped on that means I’m beyond saving? So before you step foot in the room - hell, before you’ve even had that first consultation call - you’re going over your whole story, trimming off the bits that seem too ‘rough’. You want help, but you don't want to seem like you need it.

Therapy is the space where you don't have to do any of that.

You can tell your whole story. You can swear. You can turn up not having a clue where exactly to start. You can cry. You can look off to the side trying your hardest not to cry. You can sigh, sink into your chair and say out loud “why the fuck is this happening to me?”. 

All this and more, because the person opposite you is neither judge nor jury. A counsellor is just another human being, first with a desire to help, then with the training to guide you in exploring the knotted mess that is your thoughts & emotions. 

What Do You Actually Talk About In Therapy?

Can I share with you how my first therapy session started? The first thing I said to the therapist was “I feel like I’m going to explode.” 

This is 2021. I had just turned 30 at the time. I felt the weight of expectation on my shoulders and suicidal thoughts swirling around my head. What an opener! That one sentence carried so much in it that I didn't know how to say. But that was okay. The therapist didn’t panic. Instead they helped me begin to untangle it in that first session. 

Where you only see chaos, the therapist finds ways to move you towards clarity. Here’s what men tend to bring to therapy. Not in a tidy list, but in the way it actually arrives.

A relationship that’s breaking down, or has already broken. Not just the practical fallout, like who gets the dog, but the part underneath. The overwhelming feeling of feelings that you struggle to name. The guilt, the anger, the loss of a version of your life you thought was settled. The fact that you’re not sleeping and can’t tell anyone how bad it is.

Perhaps it's a low-level dread that follows you around. You’re doing fine on paper — great, even, by society’s measuring stick for men. You’ve got the job, a relationship, mates…but you’re just not feeling it. Is this all there is? You’re wondering if this is just what being an adult feels like, or if something’s wrong.

Or it could be thoughts that feel too dark to say out loud. The ones that come when things are at their worst. Men bring those here too, more often than you’d think. 

40% of men surveyed say it would take thoughts of suicide or self-harm before they'd ask for help. You don’t need a diagnosis, and you don’t need to be in crisis. You can come because something’s off and you can’t put your finger on why. If you’re not sure whether what you’re carrying is enough to bring to therapy, I’d say: if it’s taking up space in your head, it’s worth talking about.

I work in-person from my practice in Digbeth, supporting men across Birmingham and the West Midlands. I also provide sessions online UK-wide.

How Long Does Therapy Take?

The first time I did therapy I went for 3 months. The second time was for six weeks. And the third time, I stayed for seven months. I worked on different things each time. 

So the simplest answer is: it depends on two things really, what you’re bringing and how long you want to stay. 

I think sometimes people forget they have a say in the matter as well. You’re not signing a neverending contract. And with me your sessions don’t have to be back to back, week on week. Several of the clients I work with see me bi-weekly or monthly. I don’t believe therapy has to follow a set schedule; I do believe in respecting your autonomy as a client.

That’s why I ask at the end of every session “would you like another session?”

You may see me just once and decide that’s exactly what you needed.

What Actually Happens In The First Therapy Session?

Well, first there’s the consultation call. Most counsellors will offer one for free. It’s great for getting a sense of each other and you can work together.

In this call, I’d ask a bit about the circumstances bringing you to therapy and what you want to change. We’re already establishing the goals, if you will, for therapy. This means when therapy starts I can pick right up from that consultation and get straight into the work.

The session tends to be about really fleshing out what you perceive as the ‘problem’, exploring its influence on different areas of your life and then identifying what you’d like to be different. And while there may be lots of therapeutic theory & techniques buzzing around my head, I promise you won’t be overwhelmed with jargon or clinical labels. 

My priority is giving you the space to be yourself, providing a structured conversation that helps you move towards clarity.

When to Think About Getting Support

Not everyone needs therapy. 

But if you’re finding yourself short-tempered at home and not sure what’s driving it. If a relationship has ended and you’re not moving through it the way you expected. If you’re functioning fine on the outside but internally running on fumes. If you’re having thoughts about not being here. That’s something we can work with, directly and without judgment.

Therapy doesn’t flip a switch that makes everything right as rain the next day, but it can be a place where you can take the ‘I have everything under control’ mask off. 

If you’re based in Birmingham, the West Midlands, or further afield in the UK and any of this sounds familiar, you’re welcome to get in touch. No pressure. Just a conversation about whether therapy might be useful.

Frequently Asked Questions

Do I need to have a serious problem to come to therapy?

No. Therapy isn’t only for crises. Men come to therapy for all sorts of reasons, like wanting to understand themselves better, or because something feels off in their life/relationships and they can’t work out why. You don’t need a diagnosis or a breakdown to qualify.

What if I don’t know how to talk about my feelings?

A lot of men who come to therapy say exactly that in the first session. You don’t need to arrive with the right words. Part of the work together is finding them.

How do I know if a therapist is right for me?

Most therapists offer an initial consultation, which is a short call or first session to get a sense of whether it feels like a good fit. The relationship between you and the therapist matters as much as the approach they use. If it doesn’t feel right, it’s fine to try someone else.

Is therapy for men different?

Working specifically with men means understanding the particular pressures men carry: the expectation to cope quietly, the difficulty asking for help, the way certain emotions feel much harder to name & access compared to anger, frustration or the desire to withdraw. A therapist who works with men is attuned to that from the very beginning.

How much does men’s therapy cost in Birmingham?

Private therapy for individuals in Birmingham typically ranges from £50 to £100 per session. Fees can vary depending on the therapist; some also offer a sliding scale based on income. It’s worth asking when you make contact. Most therapists won’t make you feel awkward for asking about cost, ultimately it needs to be affordable for you.