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Men and Depression

An Interview with Terry Real

© 1998 by author


This article appears in Vol. 1 #3 (Summer/Fall 1998) of Men's Voices journal.
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Terry Real

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

by Terrance Real
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Terry Real is the author of I Don't Want to Talk About it: The Secret Legacy of Male Depression. The book has been highly recommended to me by therapists, by men who have been fighting depression, and by men to whom the book has spoken quite eloquently. When Terry was on a tour to promote the paperback release of this book, I took the opportunity to talk to him just before a reading at the Elliott Bay Bookstore.

Bert: I usually begin by asking how a person first became interested in men's issues. As I understand it, you began with traditional therapy training and doing therapy with men, and something came up that broke you out of that pattern.

Terry: I've been moving further and further out with each passing year. I trained in traditional therapy and social work, doing traditional Freudian work in Boston, which is very conservative. Then I got bored with that and moved into family therapy, which is really exciting. It's like moving from 2-D to 3-D as you move into systems and explore how systems operate. After a while my wife Melinda, who like me is both a family therapist and a trauma survivor, stumbled into recovery work with a 12-Step recovery woman named Pia Mellody. John Bradshaw has really popularized a lot of her ideas, as well as her own inner child work and trauma recovery work. I moved into looking at addictions and trauma. I've always had an interest in gender. So I haven't been a straight Boston therapist for quite a while (chuckling.)

It's interesting how I started looking at men's issues. I'm a family therapist, predominantly. I do see individual men and women, but most of my work is with relationships, either in a family or in marriage.

I didn't come to this book, it came to me. This is an interesting story, in and of itself. There's a grand doyen in the field of family therapy, by the name of Olga Silverstein. She's in her late 70s. She's one of the first feminist family therapists, and just a powerhouse of a woman. She's been an unofficial mentor of mine for a while. In my own work I decided to stretch out a bit. I dropped Olga a note, and said, "Would you like to be an official mentor?" Olga had just been reading Robert Bly's Iron John, and she was really incensed with the idea that only men could mentor men. That's one of the things that she took from the book. So she was very tickled that this youngish, 40-year-old man would be asking this 70-year-old woman to be a mentor. She had been doing a book on mothers and sons, The Courage to Raise Good Men, which I see in some ways as being a companion to my book.

The people she was working with wanted to do a book on men and depression. I hadn't thought much about depression, to tell you the truth. I was a family therapist and hadn't thought that much about this diagnostic category. But for years what I had been thinking about was men in pain. I was really, really talented at sitting with a guy who was anything from out of touch to a Class A son of a bitch, and reaching past whatever the problem was and getting in touch with the pain. I was really good at that. I think I had years of training, being my father's son.

Bert: You did an incredible piece about that, in your book. My review of it describes it as a piece of literature, a story as much as a book about therapy. The feature in our magazine that our readers enjoy the most is men's personal stories. You did a wonderful job of weaving the story of your father through the book.

Terry: Thank you. It was really important for me to do that. It was a powerful story. He was a powerful man. There was a lot of love between us, and a lot of violence between us. It's so typical of men's lives, isn't it, that fusion of love and violence.

Bert: In one sense your story is unique, because you reached a form of closure with him, before he died. So many men don't. Their fathers may have died five or ten years ago, and they never heard the words of love or blessing.

Terry: He literally did bless me. There's that wonderful scene in the book, which is true, when he was already badly paralyzed with ALS, Lou Gehrig's Disease. My mother was holding him. I had sent him a copy of Sam Osherson's book Finding Our Fathers. I said that that was the kind of work that I did with men, and asked him to bless it. As my father grew more diseased and more terminal, he turned into a nicer guy. Sometimes it takes a terminal illness to really soften a guy up (chuckling). It's short-lived, but it's effective.

So there's this scene where I call my Dad and my mother is holding the phone. My dad sort of kicks back to give me the blessing I've been waiting for all my life, and my mother drops the phone! They start yelling at each other, bickering, and I'm saying into the phone, "Guys, guys, can I have my blessing now, please?"

He finally did give it. He gave a wonderful blessing, one that was far beyond what I expected. For once, he gave me something that was more psychologically astute than I had asked for. He said, "May nothing in my past, or your past, or our family's past impede you in any way. And may you realize your full potential." That was his blessing.

Bert: That's just beautiful.

Terry: Yes, it really is beautiful.

Bert: And so many men hunger to hear that.

You connected this with men's pain. What were you seeing in men's pain? How was it showing up?

Terry: Here's the thing that makes my work so unique and so interesting. Where it showed up mostly was in bad behavior. That's what was hitting me. As you know, a sort of typical run of the stories in my book is that a guy gets dragged into therapy by a woman, pretty much kicking and screaming. He is pretty clueless about just how difficult he is being in the world. The first order of business is to get him to see what a big problem he is to be around, particularly to himself, but also to the people around him.

It's kind of like an M&M thing, with a hard shell and a gooey center. A lot of men show up, not with the internal pain but what they're doing to run away from it. I talk about looking at three areas of running from this depression, what I call "covert depression." One is self-medication; drinking, drugging, womanizing, spending, workaholism or whatever.

Bert: A much broader definition of addiction than some people have.

Terry: Absolutely. I've really made a lot of therapeutic hay by paying close attention to milder forms of defenses or addictions than would normally cross the path of a therapist. For example, there's a true story I tell of a guy who was a lawyer who did very well, but when he came home he did what he called "unplugged." He went into sleep mode. He did nothing. He was medicated up to the gills. He had done a lot of therapy. Nothing touched it. It took me about six months, which gives you a clue how bright I can be sometimes (chuckling). But I finally asked him, "When you're doing nothing, what exactly are you doing?" It turns out that what he was doing was eating steak subs and watching television until 3 or 4 in the morning. In my head an alarm went off that said this was a TV addiction and a food addiction. But it wouldn't come across to most therapists that way. Then I said, "What would happen if we unplugged the TV and got you to a nutritionist and into some moderation in eating? Damn if he didn't have an anxiety attack on the spot, just from hearing the question. To me that said, "OK. We're moving. There are signs of life!" It didn't take him more than three or four months to move out of the depression he had been in for over 20 years, once we took the addictive dependence away.

John Gray writes in Men Are From Mars, Women Are From Venus that guys move into a cave. I hate that view! I like to say "You're in your cave, what's in there with you?" The guys I know have well-appointed caves. They have shag rugs, CD players, really nice stereo systems, a bag of marijuana, a couple of martini shakers, and what have you. What I do is try to kick out the props that are holding this depression or this lack of relationship in place. A lot of guys are comfortable with their discomfort, and I try to make them less comfortable. That's the first order of business.

Bert: I want to come back to that theme later, because it ties into your whole approach. What you say in your book is that we don't think of men as depressed, because we think of overt depression, and more women show signs of that. But you're talking about covert depression that expresses itself in addiction or workaholism. But you said it shows in two other areas. as well.

Terry: The other two areas are isolation and lashing out. Isolation: is the guy really pulling away, hiding from life? Lashing out can run the gamut from increased irritability to verbal and even physical abuse.

Bert: So you see depression, for example, behind a lot of domestic violence.

Terry: I do. I like to answer these questions with a story. In my book I talk about Jimmy, a kind of a blue-collar young man working the Boston Big Dig. When he came home his wife was on the phone. She was on longer than he thought she should be, so he ripped the phone off the wall and handed it to her. Six months before, the thing would have escalated, and the police would have to have been called.

I take some time with Jimmy in the book and I really detail what's going on. Here's how I see it. There's an underlying depression or pain, or shame, or abandonment. I can't be too linear about these things, so pardon me while I wander. Do you know that the one factor that we can identify that distinguishes a cohort of battering men from men who don't batter? We've only identified one factor, so far, an increased sensitivity to abandonment. Isn't that interesting? If you show guys a film clip, then give them a questionnaire that scans for feelings of abandonment, the battering men will uniformly answer more sensitively or responsively to feelings of abandonment than normal people.

Bert: That brings up something you said in your book. There's all this stuff Deborah Tannen wrote about in You Just Don't Understand, about boys being naturally more aggressive and girls more relational. You spend some time talking in your book about boys maybe being more emotionally sensitive than girls are.

Terry: Yes. If anything, the early studies are that very young boy children are more disturbed when their moms leave. They're more expressive. A psychologist and family therapist named John Gottman did some interesting work. He had some couples in a lab and he wired them to see their autonomic nervous response reactions when they went about their business, fighting, talking or whatever. The surprising result there was that men had higher physiological rates of arousal in the same emotional transaction than women did. He posited that men may actually feel feelings more strongly than women do. He thinks that this may be implicated in why men find emotions more aversive.

The main point is this: men are just as feelingful, just as relational, just as connected, just as dependent, just as needy, as women are. The idea that women are relational and men are rocks is just nonsense. I don't believe that men are from Mars and women from Venus. I think we're all from the same planet. What's going on is that men had been coerced since boyhood to forego these relational qualities and skills and squeeze their sense of membership and self-esteem through performance. I believe that in this culture neither girls nor boys are taught healthy self-esteem. Girls are taught to filter their sense of self-worth through connection with others, and boys are taught to filter their sense of self-worth through performance. That's a very vulnerable foundation for one's sense of self-worth.

Bert: That brings up one of the points in your book. Girls know what "feminine" is. Boys define "masculinity" negatively, by what masculinity is not. It's not, "I am strong," but "I am not weak."

Terry: It all boils down to "I'm not a girl." You're not worthwhile simply because you're here, you're alive and you're breathing. You have to prove your worthiness. That's a very insecure basis for a sense of worthiness. Underneath this esteem issue it's really about love. It's about wanting to belong. It's no different for men than for women. Why men are motivated to kill themselves by working themselves like dogs, is love. They want their boss to love them. They want their colleagues to love them. They want their families to approve of them. That's our ticket to relational connection.

Bert: I want to stay with that for a bit, because it flies in the face of what we're traditionally thinking, that men strive for success, or for achievement. What you say they're really striving for is to get that love and that relational connection.

Terry: Yes, and that's a really deluded way of going about it. It's funny that you should find that fine. To me, it's sort of the earth story of Western civilization, the Perceval myth. He sees the knight. His mother literally drops dead on the spot. He goes off on his adventures. He slays the dragon, wins the Grail, and then wins the princess. That's the way it goes. First you turn your back on relational connection, separate from your mother, I think way too unnecessarily early. Then you go off and conquer. You are into dominion, not cooperation with but power over. Then when you've proven that your muscles are big enough and you're strong enough to be really worthy, then guess what you get? You get the relational qualities that you, yourself turned your back on as a boy. That's the dream. But it doesn't work like that.

I deal with a lot of entrepreneurial guys, who are now in their 50s and 60s. They've made their "screw you" money and have several million in the bank. Their wives hate their guts and their kids are alienated. I have one guy whose kids call him an "occasionally visiting autocrat." One of his daughters calls him "a blank check and a smile."

It's sort of like the myth of Midas. That's an interesting myth. The guy had the golden touch. The punch line of the story is when his beloved daughter throws herself into his arms, and she turns into gold, too. Here he is, he turns everything into gold, but he can't eat. Food turns into gold. He can't digest it, and he's going to starve.

Bert: The group you're talking about sounds like the men we see in the "men's movement," the guys who go to gatherings. It's said, "I climbed the ladder of success, only to find it's up against the wrong wall."

Terry: That's great! I love that!

I love Robert Bly and I love the men's movement, but I think it has to go further. The best of the "mythopoetic men's movement," if you want to call it that, is really about rekindling spirituality and communion through spirituality. I totally agree with that. The movement toward having a retreat from one's family and one's life, to go into the community of men and re-charging is wonderful and there's a valuable place for that. But I think there's much more to be done. I'm a family therapist, so as I said to the guys at a recent retreat, it's all well and good to work on these recovery issues with other men, but then the issue is coming back to your wife and your family, and working on your spirituality and your recovery at home.

Bert: So once you cry for your first time at a retreat and show your openness and your vulnerability in front of other men, and find out that you aren't "dissed" for it, but are respected and loved, you should then come home and be more open and vulnerable, sharing of your emotional life in your relationships.

Terry: That's the direction to go in, obviously. It's sort of like the difference between doing something well when you're on a vacation and doing it at home. I jog when I'm on vacation, but when I'm home I sit in front of the TV.

It's harder to do this work with the people you're living with, but I think, frankly, that it's more urgent. I don't think, by the by, that going off on a retreat to do this work automatically means that you're going to be able to come home and do it. You may need more help to do that. A lot of the therapy that I do involves teaching men relational skills.

Here's what it boils down to. As a culture, it's like we've taken a piece of paper and drawn a line down the center, saying that everything on this side of the line is feminine and everything on the other side is masculine, and woe unto that little boy or little girl who dares to cross that line. Women have been complaining for the last generation about the forces that have brought to bear on women to stay on their side of the line and the consequences of that. My work is about the reciprocal story for the boy. The half of the humanity that girls have been pressured out of has to do with power. The part that boys have been pressured out of has to do with connection.

When I'm dealing with a depressed man, I'm dealing with a man who has been cut off. So the work I do, and it's very active therapeutic work, is about teaching men the relational skills that have literally sometimes been beaten out of them as children. In the same way that women grouped together a generation ago to help each other learn skills around assertiveness and power, men need to do that around relatedness.

Bert: One of the themes in your book is that depression is a relational disease, and that you treat it by working on relationships. In this vein, you mention a client who described your work with him as "family therapy with myself." You also called depression as an "auto-aggressive disease."

Terry: Yes. Those are all slightly different things. Let me say something about the idea of depression as an auto-aggressive disease. I wish I could take credit for it, but Sigmund Freud is the one. He didn't use that phrase, but he talked about depression as aggression turned against one's self. The thing that's important about that is understanding that the root of male depression is violence. And the core of gender socialization for little boys is violence. The way that we "turn boys into men" in this culture is through severance. We turn boys away from their mothers, from their hearts, from other people. The cost of this is disconnection, a disconnection I call the normal traumatization of boys. What happens is that men have overt depression take this violence and turn it in on themselves. Men who have covert depression don't want to bear this violence. I don't blame them. They either try to run from it through intoxication or burying themselves, or they inflict it on other people.

I think that the wounds that men are dealing with are wounds of disconnection. They are fundamentally relational wounds. I think the solution has to be fundamentally relational, as well.

Bert: When you talk about this severance and wounding as young boys, what about routine genital mutilation? Sam Keen says, sarcastically, that we teach boys about love and affection by cutting off the end of their penises. Many people opposed to circumcision say this is a teaching of violence rather than love, and the traumatic pain they experience can carry forward for the rest of their lives.

Terry: I was in Masai country in Tanzania one time, talking to a man about circumcision when the youth is about 14. He was recalling a friend of his who flinched during circumcision. He didn't call out or anything, just flinched. He was so shamed by his village that he had to go live in another village.

I talk about this a lot in the book. I reel off these initiation ceremonies. I'm with Sam Keen. I think the last thing we need in this society is more warrior imagery and more initiations. The whole point of initiation of boys, as it's done in many cultures, is the celebration of their being wounded and withstanding the wound.

We don't do that that much in our society. Circumcision is moved from the really horrible adolescent initiation that leaves many boys dead. The way that I say it is to talk about the emotional circumcision that we do, the lopping off of the boy's emotional psyche is done on a daily basis, over and over.

Bert: There are studies that show that if a boy falls in a playground his mother is more likely to tell him to wipe his tears and "be a little man," but the girl will be picked up, held, and comforted.

Terry: The very phrase "be a man" means "disconnect." Disconnect from your own feelings and play through the pain. The thing that people are tumbling onto is that the other word for these transactions is violence, trauma. Men walk around with these deep, deep wounds, coupled with an entitlement to mishandle these wounds by irresponsible addictive or violent measures. When you have a hurt little boy walking around in a big, grown man's body, with centuries of male prerogative, that's a pretty volatile combination.

Bert: You also describe grandiosity as a reward for performance esteem, but also a neat way to stay in that addiction. Basically, what you're saying is that treating depression is a three-step process, of dealing with the addiction, then moving into a relational maturity, and only then do you get into the underlying pain. That seems to be contrary to hat some other people are doing, when they say "get in touch with that childhood wound," or hitting the pillow and getting into that anger work right away. You say there's a lot of other work that needs to be done first, otherwise it's too emotional and dangerous to bring out.

Terry: What happens is that you go beat on your pillow, then you go home and beat on your wife. You feel better, but I'm concerned about the people around you. Unless somebody's done the work of getting sober, when they get into the emotional work they're going to self-medicate with whatever's going to work. The two pieces start with getting the man into sobriety and giving him some support so he's not alone I that, and teaching him about relational responsibility. Those things have to be in place, because once you start to hit the geyser of those raw feelings, it's very tempting to act out. I've been there. You're in a rage, you're hurt. You don't want to feel the pain. Somebody walks into our face and crosses you, and you're not a very pleasant person to be around. The other thing is that a person can be in touch their wounds until they're blue in the face. I know a lot of guys who are working their wounds, but they're still creeps to be around.

In the work that I do, I talk about two inner children. I learned this from Pia Mellody. There's the wounded child, who was young, who was on the receiving end of the abuse. But there's also the adaptive child, which is the pat of you that took on the mores, the privileges, the false empowerment and the point of view of the perpetrator.

Bert: Like the kapos that Bruno Betttelheim talks about from concentration camps, the prisoner trustees who are more Nazi than the Nazis. Identification with the perpetrator.

Terry: What I'm saying is that, for boys, the excruciating dilemma is that you either join the culture of masculinity by being contemptuous of vulnerability and connection, or you risk getting raped yourself. You're either a guard or a prisoner. you're either a hammer or a nail It's this adaptive child that runs around creating havoc among the people around them. Just getting in touch with your wound, while it's all well and good, can also be like a flywheel with no axle hooked up to it. You can have all these wonderful, cathartic experiences, go home, have a couple of highballs and act like a bastard. That's not really progress.

Bert: Then when you talk about confronting your pain, you have a startling quote in our book. "The only cure for covert depression is overt depression." That reminds me of what Robert Bly says when he talks about diving into the ashes, into the grief, into the pain, to live through that pain and come out the other end.

Terry: The good news, though, is that you can live through that pain and come out the other end. All this running around and building yourself up with a fortress of women, or money, or drugs, or whatever you're doing, does work. In the short-term, it alleviates the pain. But it just creates a numb, dead and trouble-filled life. It's sort of like the AA concept of "bottoming out." The great awakening is the realization "I don't want to be this kind of man anymore. I want to be a different kind of man." I believe that more and more men are coming to this realization. You and I would not even be having this conversation ten years ago. I think there is a subculture that is beginning to grow, that is supporting men in stepping off the conveyor belt.

Bert: I wonder if it's so slow. I was thinking about that as I was reading in your book about men being beaten by their fathers. Aren't we already in a generation where people have caught on that that's not the way to bring up boys?

Terry: I think things are beginning to move. I think that consciousness has been raised about physical abuse. Fathers don't whip out the strap like they did a generation ago. A friend of mine talked about "normal historical discipline which we would now call child abuse." But there are lots of ways to abuse a kid: for example, if you work 80 hours and are never there, or if you're gruff, or if you yourself are so busy self-medicating your internal pain that your kid is not that much of a priority to you, or if your kid is a priority to you, but in some diffuse way, or he watches you abuse his mother. I don't think that people are as blatant and flagrant in upper-middle-class white society as they used to be. But I think boys are still being pretty damaged.

Bert: What would be your message to people reading this?

Terry: I think, first of all, that the men's movement needs to go further. I think that one of the things that unites movements as disparate as the Promise Keepers, the mythopoetic men's movement, the psychological writing about men, and all the popular work on gender, is hat it does not explicitly say that traditional patriarchal roles have done damage. Almost all of the men's movements that have been allowed to flourish in this culture try and work out issues of masculinity while still staying within a certain patriarchal frame. I'm not interested in helping people to live well within a patriarchal frame, I'm interested in blowing it up. I'm really interested in joining with women and having both men and women tell men and women that traditional gender roles do a lot of damage, not just to girls but to boys, not just to women but to men. It does a lot of violence to the relationship between them. We really would be better off moving to a place where we teach our children to be grown-up human beings. When we stop trying to squeeze our kids into some cookie-cutter idea of what makes "manly" men and "womanly" women.

My message to any man, or person connected to a man who might be struggling with depression, is to get help. Depression is really a treatable disorder. It's a heartbreak that fewer than one in five people ever get treatment for it. This is true if it's back-breaking, miserable depression, or if it's so-called mild depression, where you just feel sort of gray and not that much fun to be around, lugging this dead weight, which a guy can do his whole life. You don't have to tolerate that any more.

I also have a message for mothers who are raising boys. Don't be afraid of your closeness to him. Don't be afraid to insist on relationality in buys, in the same way we've grown to insist on competence in girls. Boys will take some flack, from their peers especially, if they really stay open and relational, but so what? We can support them in that. We don't have to be cowards.

I'd like to see the culture change. I'd like to see more people like you doing interviews like this. When you think of the support that a young woman has, in breaking out of roles, Ms. Magazine and all the consciousness-raising groups, and you contrast that to the almost total aloneness a young man has in trying to break out of these roles, I think it's time for us to help a young man like that by creating some kind of a counter-movement or counter-wave that he can feel at home in. That's partly why I'm here.

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