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

by Terrence Real, Adam Verner (Narrator)

The author reveals how many men, feeling the stigma of depression's unmanliness, conceal their condition not only from their families and friends but also from themselves.

Genres: Psychology, Nonfiction, Self Help, Mental Health, Health, Relationships, Personal Development

Audible Audio

First published January 1, 1997

About the author

Also writes as Terry Real.

Terrence Real is the bestselling author of I Dont Want to Talk About It: Overcoming the Secret Legacy of Male Depression and How Can I Get Through to You?: Reconnecting Men and Women. He has been a practicing family therapist for more than twenty years and has lectured and given workshops across the country. In March 2002, Real founded the Relational Empowerment Institute. His work has been featured on NBC Nightly News, Today, Good Morning America, and Oprah, as well as in The New York Times, Psychology Today, Esquire, and numerous academic publications. He lives with his wife, family therapist Belinda Berman, and their two sons in Newton, Massachusetts.

Reviews

[Michael Britt · Rating 5 out of 5]

There needs to be a 6th star option for this book. This is by far the most important and impactful book I've read in recent memory. This is a subject that doesn't get talked about, and that many feel like they can't talk about, so that's why it's so important. So many men going through life carrying and passing on their burdens of shame and depressions, some not realizing it, and some not meaning to. We all do it. Because we can't talk about it. Or at least we're made to feel like we can't talk about it. "Man up" they say. "Stop being a sissy/gay/a p***y" they say. Even at a young age "boys don't cry, only girls do". I don't think we realize what an impact saying something as simple as "boys don't cry" can have on a child. That leads us to internalizing and holding on to all of that depression and sadness. Which either manifests as outright depression, anger, rage, or other emotions that you wouldn't think would have anything to do with internalized depression. He gives us some amazing insights into some of his past patients. Many of whom are domestic abusers, sex addicts, work addicts, drug addicts, alcoholics, etc. The shocking thing is just how many of these men have underlying trauma from their childhood that they felt they couldn't ever address. So they buried it deep down and eventually "forgot" about it. But it ended up manifesting, more often than not, as what had been done to them. It becomes even more apparent that the old phrases "hurt people hurt people" and "violence begets violence begets violence" is more true than we think. These are subjects that desperately need to be discussed so we can heal those who are hurting people, or boys who may grow up to be perpetrators of the violence that is bestowed upon them that they never asked to burden.

[Richard · Rating 5 out of 5]

About half-way through. Subtitle could be "Masculinity in the Simon Family Tradition"-- I can picture generations of us reading this and saying, "How the hell did he find this out about me? I've never told anyone..." One or two might then look at the title and do a Homeric "DOH!" But forget about them-- I'm all over these pages. Less so now, by degrees, but there's still so much I haven't sat with, and didn't have the words to name, so I'm still going... I'll be back once I've finished (the book, not the process).

Meantime, can't help thinking of the stock situational irony that those who need this book most will never hear of it, much less read it. If you know one of those guys, press a copy into his hands.

[Emily · Rating 3 out of 5]

Interesting analysis of how depression manifests itself differently in men than the "classic" symptoms generally thought of. Especially good discussion of how violence, workaholism, and depression are passed from parents to children, particularly sons.

As a mother of boys, I also appreciated the sections on society's expectations of masculinity and femininity and how reinforcing those stereotypes can do damage, teaching boys that they can't express their emotions.

The descriptions are therapy session with the composite patients were touching, and personal enough to draw you in, but almost made it seem too easy. I'm sure more work went into the therapy sessions than it seemed.

There really wasn't any discussion of depression in men that isn't due to some sort of abuse or neglect as a child. If there's no major childhood trauma to work through with your therapist, then what?

For more book reviews, visit my blog, Build Enough Bookshelves.

[V · Rating 5 out of 5]

Probably the most significant book I’ve read in months.

I think I see my mental health differently, especially some of the causes (having lived my entire formative life in a performance based self esteem driven culture) and effects (believing I have self worth only if I am playing the game well, the sort of self medicating coping mechanisms I’ve developed to deal with the emptiness I feel so often)

I think I also see other men and boys differently. I don’t think I fully realize the corrosive effect our patriarchal society has on how boys see themselves…think I have much more empathy for the foundations of more repellant forms of male behavior.

“If patriarchy silences girls’ voices, it also takes aim at boys’ hearts”

[Jake · Rating 5 out of 5]

As happens with lots of college students, there came that point where I needed to talk to someone. It wasn’t just that I was in over my head, it was that I didn’t care and didn’t plan on getting better. On my second try, I found a therapist who was a good fit for me. She had a different background and a different perspective. In addition to being great to talk to, she pointed me towards some helpful literature. Easily the most beneficial thing she had me read was this book, I Don’t Want To Talk About it: Overcoming the Secret Legacy of Male Depression.

It’s not so much that men suffer something women don’t, or more of it. It’s that the book zeros in on men. Mr. Real comes at the issue understanding personally what it means to be a man, for better and worse, in modern society. He writes with empathy and with expertise. And he isn’t blindly optimistic. He shares examples of depression sufferers who don’t get better too. But the prevailing message is one of practical hope. What I took away from reading this book is that it’s not about some frantic and futile quest for bliss. It’s about achieving a stable temperment and realistic perspective, and then bravely struggling on with this thing called life.

I’m grateful for the book, the author, and the therapist who recommended it to me. It helped.

[Josh Czinger · Rating 4 out of 5]

This was the first book I've read on this particular topic, and it was a bit of a pail of cold water in that it was shocking and refreshing. The author draws extensively from his own personal experiences with depression as well as the stories of the patients he's worked with. This creates a cross section of examples of overt depression that he then connects back to the covert depression that is harder to identify. He identifies a few methods and tools that can be used to bring the causes to light, thus allowing for them to be addressed. His methods are interesting and at times shocking. The best thing about this book is that it does not sugar coat anything for the reader, but presents things in a stark yet caring manner.

My favorite fact from the book is that the average child gets just 11 minutes of attention from their father per day, but watches an average of 28 hours of television per week.

[Haley Graham · Rating 4 out of 5]

This book is going to be something that I continue to think about for a long time. It was published in '98, but so much of it still holds up as if it were written yesterday. I think it should be a mandated read for those raising boys!
I would be interested if an afterword or an extended edition was ever in the works because I think there's some intersectionality that could be interesting and expanded upon. Also including some nuance around gender in extended editions for those who might find themselves somewhere in the middle. I saw that less as a way to politicize but more so out of genuine interest and curiosity!

[Ed McKeogh · Rating 5 out of 5]

(1) Thank you, Mr. Real, for THIS. AMAZING! BOOK.

(2) For the better part of my life, I've felt out of step with social expectations and not understood why. After reading this book, I get it. I finally get it. I feel as though I've been wandering in the wilderness for a long, long time, when I suddenly find myself standing before an information-rich, emotionally wrenching though inspiring and hopeful "You Are Here" sign. It's almost laughably easy to trace where I've come from, and it's heartening to know there are course corrections available to me that will lead to a healthier, more robust life.

(3) Lest it seem as though I'm attributing magical powers to this book, let me assure you that it's my unbridled enthusiasm talking. Realistically, some aspects of the book, now 15 years old, may seem like a retread of now-familiar material to new readers. And it's certainly contrived in some places; the stories Real shares are composites, deliberately meant to evoke a particular emotional response. For the sake of focus, a number of factors that contribute to a person's maturation process are not addressed in these pages. And some readers may find the autobiographical elements distracting.

But just as Brene' Brown's work, which focuses on women, yields rewarding information about the human condition, so too does Real's work. (In fact, it was during Dr. Brown's podcast that she suggested Mr. Real's work for her male readers.) Real challenges commonly held beliefs about men and masculinity in an engaging way and reveals that certain stereotypical "male" behaviors--many of which are not only approved of but also praised, encouraged and validated--are addictions that deflect attention away from deep emotional wounds that have been inflicted on men down through multiple generations. His stress on the fact that depression manifests differently between the sexes mirrors Dr. Brown's assertions about gender-specific experiences of shame. And Real provides a useful and descriptive language for talking about these issues, especially useful now that the cultural value and role of men are undergoing rapid and dramatic changes as a result of the ongoing economic crisis.

If I could give one book to everyone I know this year, I would unhesitatingly choose this book. A richer understanding of men can only benefit us all.

[Kevin Orth · Rating 5 out of 5]

One of the best books on the topic of depression. Men and women are equal - and not the same. In some ways, we experience ourselves differently and society has different pressures and expectations. Any man who has experienced depression, anyone who loves a man who has experienced depression would be well served by reading this book.

[Kalem Wright · Rating 4 out of 5]

“I Don’t Want to Talk About It” argues that patriarchy lies at the heart of men’s depression. Although women lose enormous autonomy and privilege, men lose the capacity to authentically connect and instead search for self-esteem through performance, dabbling in process and substance addiction to nurse their pride when they fall short. Among other ideas, Real posits an interesting and provocative argument that partners and families collude to hide the reality of men’s depression through focusing on “symptomatic” issues such as relational discord as an example of families protecting the illness.

Real argues that male socialization involves, in effect, severing anything seen as feminine, including the experience and expression of emotions. From devaluing the role women play in influencing their sons to crediting the role of sports culture in teaching how men behave, Real makes a compelling case for masculinity as an emotional disability with lifelong consequences unless treated.

There are a few problems with the book and the argument as written, however much I support it personally and professionally.

For one, although Real isn’t a historian or social scientist, his evidentiary basis is narrow. Real gives outsize credit to competition in the socialization of men, ignoring art, music, video games, and television, for example. Exploring these other domains would have provided more convincing evidence of his argument. His reliance on clinical vignettes in his Boston-area practice with men who are either personally- or socially-motivated to change their behavior doesn’t begin to touch the patients in a standard community mental health agency to say nothing of the wider community.

Additionally, although a trip through the end notes reveals good scholarship of family-therapy, recovery- and trauma-oriented, and sociological literature, it’s not clear to the reader what original ideas Real offers. At times, it seems more useful to read the works of Pia Mellody whom he is admittedly greatly influenced by. I came away from reading the book impressed by Real’s therapeutic insight and theories; after reading the index, I came away impressed by his ability to synthesize others’ ideas.

Finally, it’s not abundantly clear whom the text is intended for. To his credit, Real is unafraid to ask readers to swim in the jargon of therapy and its possible even for laymen to understand many of the principles of trauma, depression, family-therapy, trance work, and addiction. However, Real’s vignettes and biography seem intended to engage laymen rather than professionals.

This all ignores as well the lack of intersectionality in his work despite its basis in feminist scholarship. Real doesn’t offer special insight for masculinity in Black communities, for example, where women historically have had a respected and influential role in the family system.

Although this review may seem like it’s harsh, I don’t intend it to be. Real’s work is an excellent synthesis of feminist scholarship, family therapy, and then-burgeoning neuropsychology and has tremendous insight for the therapeutic practice particularly with abusive men; indeed, it’s celebrated as a classic among these advocates. Like the men he treats, his work is at times hard to love but has tremendous potential to do good in the world.

[Koen Crolla · Rating 2 out of 5]

Whenever anyone complains about the lack of rigour and the prevalence of magical thinking in psychology, psychologists and other non-scientists are quick to accuse them of not knowing anything about the field and getting all of their information from pop-culture caricatures. It's interesting, then that psychologists keep writing books that conform exactly to those alleged caricatures. Real's characterisation of the field, the problems he sees with it regarding male depression, his proposed solutions, and his descriptions of his therapy sessions, are all spot-on examples of exactly the things critics tend to complain about. Even after all this time, the field is still a joke,† even though there is no reason it has to be.

To be clear, I'm not disputing that therapy has a positive effect for a lot of people; it clearly does. As do homeopathy and other forms of ``alternative medicine'', and Alcoholics Anonymous and other religious cults, for roughly the same reasons. I just get so tired of people holding up those modest successes as evidence of anything other than the fact that the human mind creates and exacerbates a lot of its own problems, and is pretty easily manipulated.

I Don't Want to Talk About It isn't strictly a book about psychology as a science, though, except to the extent that it appropriates some plausible-sounding jargon and results from other, better fields. Real's point is that depression manifests itself differently in men than it does in women because they're socialised differently because patriarchy and toxic masculinity, and that people need to stop seeing depression as a mainly female disease. Reasonable enough points, though I should say that I've only heard the claim that depression is a female disease twice in my life, and both times it was from a psychologist complaining about it. Maybe that's because this book genuinely changed attitudes, or maybe I just know too many decent people, or maybe psychologists are just more sexist than the average population; who knows.
Either way, as books by, for, and about psychologists go, this one is probably less harmful than most. It's just a shame it's still cloaked in so much bullshit.

--------

† With the caveat that the book came out in 1997, which is now eighteen years ago for some reason. My more recent experiences with defenders of the field haven't indicated any fundamental changes in that regard, though.

[Kristen Atherton · Rating 5 out of 5]

Literally everyone needs to read this book. You won’t regret it.

[Jeremy · Rating 4 out of 5]

Notes:

+ 2 kinds of abuse, both lead to disorders of self-esteem
- “Good parenting requires three elements: nurturing, limit setting, and guidance. A parent who is too absorbed to supply any one of these neglects the legitimate needs of the child”
1. Disempowering abuse
- shaming a child
- placing child in one-down, less-than, or helpless position
- sets stage for victimization later in life
- disorder of too much shame
- leads to overt depression
2. False empowerment
- lifts child up to inordinately powerful position
- pumping up, or at least not appropriately checking, child’s grandiosity
- sets adult up to become offensive
- disorder of too little shame or shamelessness
- leads to covert depression

+ On performance and achievement
- Being successful isn't inherently good, it depends on what you're succeeding at
- “Both in our own lives and in the spectacles around us, we still search for higher meaning in achievement. We still equate performance with virtue”
- “Unlike traditional mythic images of the lone, utterly self-sufficient hero, real boys and men need social connection just as much as do girls and women. A sense of self-worth always implies a secure sense of membership—a sense of mattering to someone, of being worthy of intimacy. In a healthy relationship to performance, achievement is a labor of love that exists within the context of secure connection, not an act of grandiosity that takes the place of connection”



Quotes:

The turning to any substance, person, or action to regulate one’s self-esteem can be called an addictive process. In this framework, the terms addition, narcissistic disorder, and the defenses in covert depression are all synonyms. When a covertly depressed man’s connection to the object of his addiction is undisturbed, he feels good about himself. But when connection to that object is disrupted—when the cocaine runs out, the credit cards reach their limit, the affair ends—his sense of self-worth plummets, and his hidden depression begins to unfold.

Women rate high in internalizing, men in externalizing. Internalizing has been found to have a high correlation with overt depression. When researchers compared the high rates of externalization in men with their low rates of depression they speculated that men’s capacity to externalize might somehow protect them from the disease. But while the capacity to externalize pain protects some men from feeling depressed, it does not stop them from being depressed; it just helps them to disconnect further from their own experience. The capacity to externalize helps men escape overt depression, only to drive them toward covert depression.

“Beware of ‘nice’ men with ‘bitchy’ women.” Belinda Berman, family therapist

It has long been accepted that changes in our biochemistry, caused by illness, medication, or intoxicants, can affect our psychological states. But what has been less appreciated, until recently, is that changes affecting our psychological states may alter our biochemistries as well, even the very structures of our brains.

As anthropologist Barrie Thorne points out, a woman’s basic femininity is never questioned in our culture. There may be questions raised about what kind of woman she is—flirtatious, tough, even “butch”—but it is rarely in doubt that she remains a woman, feels herself to be a woman, is not driven by anxiety about her own femininity. But for boys and men, masculine identity is perceived as precious and perilous, though not a shred of evidence has emerged to indicate the existence of this supposed precarious internal structure, masculine identity. Studies indicate that both boys and girls have a clear sense of which sex they are from about the age of two, and that this knowledge is extremely solid and unambiguous in all but the most severely disturbed children, those who are brain damaged, psychotic, or autistic. Some sociologists now distinguish between such a basic knowledge of one’s own sex, which they call “sex role identity” from knowledge of what it means to be a boy or a girl, which they call “gender role identity.” It is at this point that things grow murky. In order to be well adjusted, boys and men need to have internalized a clear, stable sense of what it means to be male. Confusion about what “maleness” means can result in severe psychological difficulties and “antisocial” behaviors.

Those boys who do have fathers are happiest and most well adjusted with warm, loving fathers, fathers who score high in precisely “feminine” qualities. The key component of a boy’s healthy relationship to his father is affection, not “masculinity.” The boys who fare poorly in their psychological adjustment are not those without fathers, but those with abusive or neglectful fathers.

You’re not breaking down. You’re crying. Breaking down happens to people who don’t cry.

Traditional socialization of boys diminishes the capacity to esteem the self without going up into grandiosity or down into shame. Traditional masculinization teaches boys to replace inherent self-worth with performance-based esteem. It insists that boys disown vulnerable feelings (which could help them connect), while reinforcing their entitlement to express anger. It teaches boys to renounce their true needs in the service of achievement, and at the same time blunts their sensitivity to reading the needs of others.

Despite the often expressed male fear that, if one were to let oneself cry, one would never stop, tears, in fact, eventually taper off if one lets them. Feelings are not endless, but our numbing attempts to avoid them can last a lifetime.

I believe that one first changes the behaviors, then, if one is lucky, the feelings follow. The same thing is true for couples therapy. If a man were to wait until he really felt like learning to be more communicative, the couple and I might sit and grow old together. Sometimes a man has to get up off the psychological couch and get going, whether he feels like it or not. This is called discipline.

Men agreed—for their and their family’s well-being—to abdicate many of their deepest emotional needs in order to devote themselves to competition at work. Women agreed to abdicate many of their deepest achievement needs in order to devote themselves to the care of everything else, including their working husbands. I call this deal the core collusion. It is at this juncture that the roles of man-the-breadwinner and woman-the-caretaker were born.

I tell the wives of depressed men: “If you directly confront this condition and do not back away from reasonable demands for intimacy, there may be a fifty-fifty chance your husband will leave you. But, if you do not honestly engage with these issues, there is a ninety percent chance your relationship will slowly corrode over time. Which risk would you prefer to take?”

The greatest cost of the less than/better than dynamic of traditional masculinity lies in its deprivation of the experience of communion. Those who fear subjugation have limited repertoires of service. But service is the appropriate central organizing force of mature manhood. When the critical questions concern what one is going to get, a man is living in a boy’s world. Beyond a certain point in a man’s life, if he is to remain truly vital, he needs to be actively engaged in devotion to something other than his own success and happiness. The word discipline derives from the same root as the word disciple. Discipline means “to place oneself in the service of.” Discipline is a form of devotion. A grown man with nothing to devote himself to is a man who is sick at heart.

[The Distracted Bee · Rating 3 out of 5]

In 1998 this book would have been 5 stars.

However, 21 years later certain subjects (e.g. expectations of male vs. female) have been explored much more in depth.

Appropriately, parts of Real’s work reads like a thesis essay, using numerous references to prove his deductions from his personal findings... which isn’t exactly what I was looking for.

What does stand up are the case histories.

I will come back to this (I’ve put it aside because I’m working on not being codependent and forcing people to face their demons when mine are heavy enough, thank you very much!) as it still is helpful if you have a male in your life that is struggling with, well, life.

[Amy Mair · Rating 4 out of 5]

I connected to this book on many levels, especially as a wife and mother. Highly recommended read. We need to stop devaluing our emotions as a society.

"Traditional gender socialization in our culture asks boys and girls to 'halve themselves.' Girls are allowed to maintain emotional expressiveness and cultivate connection. But they are systematically discouraged from fully developing and exercising their public, assertive selves--their 'voice' as it is often called. Boys, by contrast, are greatly encouraged to develop their public, assertive selves, but they are systematically pushed away from full exercise of emotional expressiveness and the skills for making and appreciating deep connection."
...
"The traditional socialization of boys and girls hurts them both, each in particular, complimentary ways. Girls, and later women, tend to internalize pain. They blame themselves and draw distress into themselves. Boys, and later men, tend to externalizer pain; they are more likely to feel victimized by others and to discharge stress through action."

[Sarah]

Helpful for understanding and contextualizing male depression. Published in 1997 but remains applicable today. A useful resource for people socialized in masculinity or anyone with men in their lives.

My brother recommended me this book as an essential read, and I did find it very relevant and informative. Be aware that, as many psychology books, it may be triggering.

One thing I didn't like was that in nearly all client cases referenced it turned out that the client had experienced some form of EXTREME trauma in their past, which they had then repressed. I worry that this may reinforce beliefs that male depression only results from severe trauma and deter people who do not have that level of traumatic past from getting the help they need.

[Yourfiendmrjones · Rating 5 out of 5]

As I’m “self-help adverse”, this was- at first- daunting to even contemplate reading. And yet, it shouldn’t be for anyone who enjoys the writer’s engaging,novelistic style in discussing the cases he lays out in chapter after chapter. Each one illustrates his points and each point is made clearer because of the open-hearted, humanistic way that the writer has.

It certainly helped me in my struggles with issues of self-hatred. Maybe it’ll help you too.

[Hannah · Rating 5 out of 5]

This should be required reading for all people who call themselves men and every pain in relationship (or trying to be in relationship) with them.

[Miles · Rating 5 out of 5]

Hey! Listen up. Let me tell you something. A man ain’t a goddamn ax. Chopping, hacking, busting every goddamn minute of the day. Things get to him. Things he can’t chop down because they’re inside.

––Toni Morrison

This passage from Beloved sums up the central message of Terrence Real’s I Don’t Want to Talk About It with uncanny accuracy. In our world, made by and for men in so many ways, we are bafflingly bad at providing the space and support for boys to become the men they truly want to be. As a result, everyone suffers. Families remain caught in brutal behavioral loops of trauma, abuse, and depression––cycles that mar the promise of each new generation. In this bold and beautiful book, Real challenges men to get off our asses and do something about it.

Terrence Real is a therapist, so this book is about a 50/50 split between theory/research and real-life examples from his work with clients. There is also a moving series of sections that explicate Real’s personal experiences with depression and family trauma. This review will focus on theory, but before diving in I’d like to say that the client and personal examples go a long way to make this book special. It’s quite grueling to read, but it’s also incredibly rewarding from both an emotional and intellectual standpoint. I’d be skeptical of anyone who said they got through it without choking up at least once or twice.

As the subtitle indicates, I Don’t Want to Talk About It explores “the secret legacy of male depression.” Real classifies depression as “an auto-aggressive disease, a disorder in which the self turns against the self” (198, emphasis his). Central to Real’s approach is the distinction between “overt” and “covert” depression, with the former being “acute and dramatic” and the latter being “mild, elusive, and chronic” (33). Much of the book focuses on dynamics of covert depression, which Real claims is more commonly experienced by men and less often diagnosed by mental health professionals: “If overt depression in men tends to be overlooked, covert depression has been rendered all but invisible” (41, emphasis his). Here’s a more detailed explanation:

"Overtly depressed men…are frozen, endlessly rehearsing repetitions of pain and despair. If overtly depressed men are paralyzed, men who are covertly depressed, as I was, cannot stand still. They run, desperately trying to outdistance shame by medicating their pain, pumping up their tenuous self-esteem, or, if all else fails, inflicting their torture on others. Overt depression is violence endured. Covert depression is violence deflected." (198-9)

Undergirding Real’s theory of depression is a similarly-bifurcated theory of trauma, which he characterizes as being either “active” or “passive”:

"Active trauma is usually a boundary violation of some kind, a clearly toxic interaction. Passive trauma, on the other hand, is a form of physical or emotional neglect. Rather than a violent presence, passive trauma may be defined as a violent lack––the absence of nurture and responsibilities normally expected of a caregiver; the absence of connection." (107, emphasis his)

"In active trauma, a child’s boundaries are violated. The parent is uncontained, out of control. In passive trauma, the parent neglects the child’s needs; the boundary between parent and child is too rigid, impenetrable. (204, emphasis his)

As these passages show, Real’s view of trauma is often framed using the parent-child relationship, but the diversity of examples in the book show how it can also play out between spouses, siblings, and relatives. It’s a complex, cyclical, and self-perpetuating problem that affects all family members, usually with disproportionate force. In a nutshell, Real posits that male trauma trickles down from father to son, carving out pockets of depression as it goes; trauma is the cause, and depression is the effect.

Before presenting what Real thinks we should do to confront and heal male depression, I’d like to highlight how and why he’s so concerned with male depression in particular. The simple answer is that he thinks men are much less likely to recognize and seek treatment for their depression, compared to women. The main reason has to do with how boys are socialized in American culture:

"For most boys, the achievement of masculine identity is not an acquisition so much as a disavowal. When researchers asked girls and women to define what it means to be feminine, the girls answered with positive language: to be compassionate, to be connected, to care about others. Boys and men, on the other hand, when asked to describe masculinity, predominantly responded with double negatives. Boys and men did not talk about being strong so much as about not being weak. They do not list independence so much as not being dependent. They did not speak about being close to their fathers so much as about pulling away from their mothers. In short, being a man generally means not being a woman. As a result, boys’ acquisition of gender is a negative achievement. Their developing sense of their own masculinity is not, as in most other forms of identity development, a steady movement towards something valued so much as a repulsion from something devalued. Masculine identity development turns out to be not a process of development at all but rather a process of elimination, a successive unfolding of loss. Along with whatever genetic proclivities one might inherit, it is this loss that lays the foundation for depression later in men’s lives.

"Just as girls are pressured to yield that half of their human potential consonant with assertive action, just as they have been systematically discouraged from developing and celebrating the self-concepts and skills that belong to the public world, so are boys pressured to yield attributes of dependency, expressiveness, affiliation––all the self-concepts and skills that belong to the relational, emotive world. These wholesale excisions are equally damaging to the healthy development of both girls and boys. The price for traditional socialization of girls is oppression, as Lyn Brown and Carol Gilligan put it, “the tyranny of the kind and nice.” The price of traditional socialization for boys is disconnection––from themselves, from their mothers, from those around them." (130)

"The tragic bind for boys and men in traditional socialization is that in order to demonstrate themselves worthy of human connection they must perform competitively, they must become winners, which intrinsically demands disconnection, the exact opposite of what they truly seek…It isn’t that men have fewer relational needs than women, but that they have been conditioned to filter those needs through the screen of achievement." (178, 184)

This book is nearly 25 years old, and that quarter century has been anything but quiet on the gender front. Even so, Real offers some of the best insights about male socialization and gender differences I’ve encountered––ones that seem just as useful today as they must have been in the late 1990s. Even though I count myself fortunate to have escaped many of the cultural manipulations Real describes, I still recognize them from my own boyhood, like old, unwelcome acquaintances. I certainly did not escape them all.

If social and emotional disconnection––brought about by trauma and sustained by depression––is a major problem for men, then reconnection becomes the main goal of recovery. When a man finally becomes capable of admitting his struggle and commits to doing something about it, he can enter the realm of what Real calls “relational heroism”:

"Relational heroism occurs when every muscle and nerve in one’s body pulls one toward reenacting one’s usual dysfunctional pattern, but through sheer force of discipline or grace, one lifts oneself off the well-worn track toward behaviors that are more vulnerable, more cherishing, more mature. Just as the boyhood trauma that sets up depression occurs not in one dramatic incident, but in transactions repeated hundreds upon hundreds of times, so, too, recovery is comprised of countless small victories." (277)

The downstream effects of relational heroism are, well, heroic:

"Each man is a bridge, spanning in his lifetime all of the images and traditions about masculinity inherited from past generations and bestowing––or inflicting––his own retelling of the tale on those who ensue. Unresolved depression often passes from father to son, despite the father’s best intentions, like a toxic, unacknowledged patrimony. Conversely, when a man transforms the internalized discourse of violence, he does more than relieve his own depression. He breaks the chain, interrupting the path of depression’s transmission to the next generation. Recovery transforms legacies." (229)

This is a stirring and inspiring narrative, one Real effectively imbues with various mythological and historical elements. It has burrowed deep into me and will stick around for years to come. I do, however, want to air a couple quick critiques of Real’s perspective. The first is a problem I seem to have with almost all of the therapy-centered books I’ve read up to this point, which is that they don’t take seriously enough the deep structural obstacles that make recovery difficult or even impossible. Real’s great at identifying and articulating the negative outcomes of male socialization, but remains mute on the question of economic, political, and technological reforms that might help men retreat from the worst versions of manhood that continue to undermine our collective well-being. To be fair, those issues are probably beyond the scope of this book, but I think it’s important to consider societal incentive structures and choice architectures, which can go a long way to make it easier or harder for men to heal without relying exclusively on “sheer force of discipline or grace.”

My second critique is another issue that often comes up when I engage with therapeutic frameworks, which is that they tend to be totalizing in ways that belie the vast complexity of human minds and mental health problems. I don’t mean to accuse Real of being deaf to nuance (he’s not), but his formulaic description of depression as always resulting from some sort of trauma feels overly simplistic. It seems reasonable to assume that most depression can be linked to trauma in one way or another, but I imagine there are some minds that manifest depression in the absence of trauma. I worry that Real’s theories might in some cases lead us to seek trauma where perhaps it doesn’t exist, or even misdiagnose depression. Although I think Real provides convincing evidence for the existence of covert depression and passive trauma, they occasionally feel like overly-capacious categories into which any negative human experience could be classified. Resolving this concern may be merely a matter of semantics, and it’s important to point out that I lack the education and clinical experience to form a strong opinion one way or another.

I’d like to end with reiterating that I found this book incredibly challenging and helpful. It’s the only book that’s ever made me cry both at the beginning and the end. I’m totally fascinated by these ideas and hope that this is just the beginning of a long and fruitful relationship with them. At the risk of drawing this review out a bit more than some readers might appreciate, I’ll leave you with a few more passages from the book’s closing pages:

"Any man who has struggled in his life with a deep, core experience of depression will need help not only in learning how to cherish himself, but also in learning the art of cherishing others. Just as the beam of contempt, the internalized dynamic of violence, may sometimes turn inward in overt depression, sometimes outward in covert depression, the regenerative force of recovery must turn inward toward increased maturity, increased self-regulation, and outward toward increased relational skill. Recovery, at its deepest level, evokes the art of valuing, caring for, and sustaining. The relationship one sustains may be toward oneself, toward others, or even toward the world itself." (320)

"Service is the appropriate central organizing force of mature manhood. When the critical questions concern what one is going to get, a man is living in a boy’s world. Beyond a certain point in a man’s life, if he is to remain truly vital, he needs to be actively engaged in devotion to something other than his own success and happiness. The word discipline derives from the same root as the word disciple. Discipline means 'to place oneself in the service of. Discipline is a form of devotion. A grown man with nothing to devote himself to is a man who is sick at heart." (322, emphasis his)

"Our interconnectedness to nature, and to one another, can no longer be denied. We live in a global economy. We share global resources. We face global threats. The paradigm of dominance must yield to an ethic of caretaking, or we simply will not survive." (324)

This review was originally published on my blog, words&dirt.

[Melissa Stacy · Rating 5 out of 5]

Published in 1997, "I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression," by Terrence Real, is a phenomenally excellent read. Part memoir, part therapy how-to, this is an empowering work of nonfiction.

Absolutely one of the best books I've ever read about masculinity and the damages of gender roles.

Highly recommended to anyone suffering from alienation, shame, unhealed trauma, and the like.

I learned so much and felt so much while reading this book.

Five stars. Recommended to everyone.

[Natasha · Rating 5 out of 5]

In 2025, a lot of what this book talks about might seem more obvious than it did when it was first published in 1997. The author takes a deeper dive into his work with men and how different life events can shape how men become men, often dating back to generations of males in their families. I liked that he took specific examples of patients he worked with to reiterate his points and often included the family dynamics with the man's children, spouse, siblings, and parents. He turns traditional stoicism upside down and teaches his patients how to be vulnerable in a world that has taught men to hide their emotions. He also talks about his own trauma and how it influenced his family dynamics. Overall, a really good read and a solid 4.5/5 - I did feel it was a bit redundant toward the middle/end, but rounded up.

[Louise Yarnall · Rating 4 out of 5]

On the death of my father, my husband recommended this book on male depression. Although I am certain Dad would have dismissed this book without a reading, I do wish I had read it years ago, mainly to help myself, my mother, and my two brothers. It provides holistic account—and a much-needed logic—of my father’s peculiar Jekyll and Hyde qualities. We sorely needed this framework at his death, when many in our family felt relief and struggled to shed tears or find laudatory words for his eulogy. Although we stayed “on message” for the memorial service, we also continued to wrestle with the hurt he left behind. This book isn’t the best piece of writing—it is a polyglot of memoir, clinical anecdotes, and scientific theory—but it does speak to those raised in homes with depressed and oppressive fathers. The basic concept of covert male depression provides a way toward making sense of the confounding aspects of growing up with these troubled men. For example, we knew Dad had an abusive Irish-American father, but we also knew that he “carried that pain,” as this book would say, singling out his own mother—and women in general—for blame rather than his dad. He let himself feel shame about his father only covertly; it came through his punitive and abusive child-raising tactics, and his high valuation of the work sphere and low valuation of the family sphere. Smug in his superiority, he gave himself a complete pass on trying to meet anyone else’s standards for being a loving father and husband or a compassionate citizen. He saw everything in his own self-serving, grandiose terms. The descriptions of the wives of these depressed men captured my mother’s role too. What can I say? She gave up so much on his behalf. She “carried his pain” too. As we now sort through the situation in which he left her, we see an uneven landscape. He left her financially set, which is a true life achievement considering his own parents’ modest means, but his form of care came with social isolation, regular berating and gaslighting, and incomplete medical attention. I understand that the culture in which he was raised also shaped and misshaped him too, but his failure to transcend those external forces ultimately forces me to see my father’s life as a cautionary and sad tale.

[George Florin · Rating 3 out of 5]

I see lots of people are very happy with the book and I understand their reasons.

On my part, I am in between. The first 8 chapters of the book are wonderful. They walk you through some of the biggest causes of male depression in the first world countries, but you can start seeing the cracks. Those are, the amount of fluff and bla in the text. But nevertheless, if you go past that, you find actual valuable information that won't change your life, but will give a better perspective of what's happening to you as a human male.

As soon as chapter 9 starts, the abovementioned fluff and bla becomes around 70% of the whole content. Therefore, you have "page real estate" full of filler words, narrator-unnecessary-comments and largely pointless dialogue that could have been summarized in two sentences. But I guess it makes for better emotional impact. Needless to say, I didn't get much value from the last 80 or so pages, it's more logical deductions from a few particular cases that the author has encountered.

Another thing I didn't really like is the lack of solutions provided. It's very easy to spot the problems, but it's extremely difficult to also provide solutions. And maybe that's what I was looking for. For me, this remains one of those nice to read awareness books, but that's about it.

[Timothy Rice · Rating 5 out of 5]

This book transformed me from a C-minus father to an A or even A-plus. I’m indebted to Terrence Real for collecting his years of therapy research to teach men how to access their feelings and stop the transgenerational cycle of unhealthy masculine socialization. I look at my son completely differently now— I truly and utterly love him. Can’t wait to read this again.

[Elsa · Rating 5 out of 5]

One of most important books I have read in order to understand, empathize and forgive myself and others. Essential reading.

[Buck Wilde · Rating 5 out of 5]

Easily the best depression book I've ever read, a title previously held by Tyson Fury's "The Fury Method", and dubiously.

Terry talks about generational trauma and the developmental holes our fathers inherited from our grandpas, and obliviously passed right on down the line. There aren't a lot of popular books about depression in men, because it usually turns into anger, antisocial behavior, addiction, or some combination of the three, each of which seems more immediately pressing.

He sees addressing the addiction as the first step to addressing the depression, which is beautifully insightful and probably why I found this book laying around at the rehab. That's best practices, if someone comes in dual diagnosis and it's possible to tease the diagnoses apart, you get them sober and then send them to for psych treatment. The Terry Method works the same way, getting sobriety on the table so the patient doesn't flee from whatever emotional sequence he's been trying to flee from his entire life, then doing roleplay-heavy family trauma work to name and face the demons in front of God and everybody. If you're reliving your father's physical abuse in front of your children with a therapist cheering you on until everybody bursts into tears, you sweep away the Miracle Gro substrate of secrecy, silence, and judgment that shame needs to thrive. No more shame, no more running, and soon the fog begins to lift.

This should be mandatory reading for anyone in the social sciences. We could be literally saving lives with this.

[Ciaran Young · Rating 5 out of 5]

I highly recommend this book to any male you know in your life.

This person may not see it all in themselves but they will know others that fit the descriptions laid out in bare form throughout.

This is more to myself than as part of a review, however it would have taken me a long time to come to this conclusion otherwise:
Although I was not a victim of active trauma as described in this book, I have come to the conclusion that there is a high probability that I was passively.
Perhaps after more reflection, I can dig deeper and accept that this led to some of my behaviours as a late teenager, in my early twenties and to this day.

As important as it is to have a support network of friends and family "... a depressed man must first learn to cherish and take care of himself. Only then will he be equipped to value and care for others"

[Jake Owen · Rating 3 out of 5]

This book was good sometimes. 20 years ago this book was probably shocking for a lot of guys to read and probably helped many men dig deeper into their own stories and I am not going to say it didn’t do that for me. But by the end, I was somewhat tired of emotional pulls at the heart and the author pulling insights from his cases. It definitely works, but the punch it had for the first few chapters definitely wore off for me. I would totally give this book to a male who had never been in a therapeutic setting and I guess that’s primarily who this book is for. So it did the job so to speak, but I wish for a bit more practicality and nuance to the things he discussed. Still valuable resource for men and women looking to understand the opposite sex more, even if it’s not in the most up to date way.

[Tony · Rating 4 out of 5]

Interesting and at times inspiring ideas about masculinity, fatherhood, and how boys and men are socialized, and how we can do better.

[Zach Anderson · Rating 5 out of 5]

Incredible and helpful. Must read for men