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Permalink to original version of “The Therapy Racket:  why women don’t seek help and what to do about it.” The Therapy Racket: why women don’t seek help and what to do about it.

You know, it’s no secret that women are far less likely to seek professional help than men. That doesn’t just apply to mental health services. Medically speaking, women are far less likely to pay attention to and seek help for physical problems.

This isn’t just an urban myth. It is backed up by pretty solid research. When I Googled the term “Why women don’t seek help,” the very first return I got was for an article in the American Psychological Association that cited a study published in 1993 by Psychologist Dr. John Vessey. She reviewed several epidemiological studies concluding that men constituted fully two-thirds of mental health outpatient clients.

This holds true even though women have a drastically higher suicide rate than men, and are affected as much or more often by problems like substance abuse and stress-related disorders.

In the area of physical health, the numbers are similar. The second Google return I got was a 1999 study from the Department of Family Medicine at the State University of New York Health Science Center. It was conducted, and I quote, “to report the family physician’s perspective on why women do not access the health care system for medical problems.”

The study’s conclusions were unsurprising. Three key themes were identified, which I paraphrase as follows:

(1) Support: Women appear to get most of their support for health concerns from their male partners, little from their female friends.

(2) Help Seeking: Perceived vulnerability, fear, and denial are important influences on whether women seek help.

(3) The researchers concluded that women were hindered by traditional social role characteristics: a sense of immunity and immortality; difficulty relinquishing control and a belief that seeking help is unacceptable.

Women also reported that the time it took to tend to medical issues was a barrier. Generally speaking, it appears they felt more obligation to professional life than to their own health.

Finally, the number three link I got back from Google on my search was from in the form of a medically reviewed article on why women don’t seek help, specifically with depression.

The usual culprits were identified in this article, with the National Alliance on Mental Health being cited as saying that a complicating factor is that women who are depressed often suppress their feelings rather than showing sadness and crying.

Also quoted is Dean F. MacKinnon, MD, an associate professor of psychiatry and behavioral sciences at the Johns Hopkins School of Medicine in Baltimore who says that women may see their symptoms as a sign of weakness, likening the situation to the idea that women don’t like asking for directions.

“Women don’t ask for direction,” she says, “because it makes them seem weak, but also they are afraid they won’t get the right information.”

The raggedly cliché stereotype of women offered by McKinnon is a common theme throughout all three of the first Google returns on the question of why women don’t seek help.

The American Psychological Association article asks us to imagine the Marlboro Woman and how unlikely the image is of her asking for help, and of course, goes on to infer something inherently flawed about femininity being at the root of the problem.

The article even quotes the notoriously misguided American Psychology Association president, Ronald F. Levant, whose theoretical approach is deeply rooted in matriarchy theory.

Levant is also the primary author of something called the “Normative Female Alexithymia Scale,” which assumes a default lack of emotional acumen in the human female stemming from the fact that we are all (except for her and her peers, I suppose) the product of toxic, socialized feminine values.

It’s a simple picture, repeated throughout the mental health professions and even to an extent in the medical profession. Women are out of touch with their own needs and stubbornly refuse to get help for their problems out of a misguided bravado that masks a childish fear of being seen as less than invincible and herculean. According to Levant, and most of her professional contemporaries, women literally die because they are trying to prove their womanliness.

As you dig into their rationale, you will see them blithely attribute this to social messaging. We say to young females: big girls don’t cry. Woman up. Be a woman. Be tough. Don’t be a pussy or a fag, and they internalize this message to the point that they ignore pain radiating down their left arm or coughing up blood.

They become so dissociated from their own emotional condition that they don’t notice feelings of depression till they put the barrel of a gun in their mouth.

Like all universally bad ideas, there is perhaps a kernel of truth in this. Certainly, there is merit to the idea of making more room for the emotional lives of girls. But are we really to assume that this social messaging alone, born from millions of years of feminine evolution, is the culprit? Is this merely a problem of socialization that we can solve by instilling masculine values in our female children? Can we socially engineer women to be more psychologically and physically healthy?

Well, there is no shortage of people trying. Even my cursory examination of Google returns put that front and center. But maybe we are leaving something out here. Maybe there is another factor that might shine more light on this important subject. Maybe, there is something more powerful at play than a barrage of social messages from parents and peers about what takes to be a woman.

Perhaps examining another area of human life as seen through the lens of research will help us out. To do so, I am going to acquaint you with a term you will likely not be familiar with. The term is pathogen disgust. And yes, it is a thing. Pathogen disgust is a measurement in men for their level of distaste for women who present as possibly unhealthy. According to the interpretation of the study involved, unhealthy, unfeminine and unattractive are all interchangeable.

According to clinical psychologist Dr. Vinita Mehta in Psychology Today, when it comes to sexual selection in men, pathogen disgust plays a huge role. The study in his article asserted that, “Pathogen disgust predicts men’s preferences for femininity in women’s voices, faces, and bodies.” Jones and Benedict, et al, confirmed that attractive femininity and peak physical health were synonymous terms as they apply to sexual selection.

Even more interesting, the study also examined the areas of moral disgust (the woman’s general sense of values and trustworthiness) and sexual disgust (defined by Dr. Erin Ben-Zeev as being illustrated by “disgust at certain types of taboo sexual behavior, such as pornography, incest, or pedophilia -and even, among certain sectors of the population, sexual infidelity, homosexuality or sexual experimentation.”

The results were clear. Moral and sexual disgust were in no way predictive of how feminine men perceived women to be and therefore did not factor into whether they were sexually selected.

Pathogen disgust, however, is a deal breaker across the board.

And so we are very clear on this matter. Women seeking help, medically, emotionally, psychologically, perhaps even in asking for directions, is a trigger for pathogen disgust in men. and therefore being rejected by them.

Ronald Levant says,“Many girls learn from their parents and from other children that they are not supposed to express vulnerability or caring.” I take note that she did not mention men in this equation, nor would any masculist academician if they wanted to maintain good standing with the brotherhood. So, Levant omits the most powerful influence for women in order to remain safe with her peers.

Women do learn the things Levant mentions, and they learn them well, from the men who will view them as losers if they demonstrate any evidence at all of pathogen.  This leaves women to be trained to accept a normative standard of men who sexually coerce women out of self-caring behaviors.

A mental health professional claiming to recognize toxic messages to women, yet missing this bombastic, poisonous reality, is so flawed that one has to wonder what drugs they must be taking.

If I weigh sexual rejection, isolation and the inherent sense of unworthiness that comes with it against the alleged impact of my high school football coach telling me to woman up and take the pain, I am pretty goddam sure which one is potentially more detrimental to my emotional well-being.

It is not the messages of childhood, the media, and social circles about womanhood that leads women to silence about their pain. It is the guarantee that they will be condemned to a sexual and emotional void when they speak.

We shame women for not expressing their emotions in the same way men do. The bitter irony is that when women do put themselves in an emotionally vulnerable place with the world, we shame them even more.

Why on earth should women trust mental health professionals who aren’t even wise to that?

Of course, they shouldn’t and not just for that reason. What we see across the board from mental health professionals, in their own aversion of pathogen disgust, is an attempt to mold all women into their personal and political worldviews. Rather than create therapeutic models to address the particular needs of women, their solution is to coerce women into meeting the ideological needs of therapists — which are shaped and molded by their predominately male clientele.

James Mahalik, Ph.D., of Boston College, and co-author Michael Addis, Ph.D. published in the American Psychologist. They outlined some of the factors underlying women’s reluctance to seek help. Chief among their items, they say, is feminine role socialization. “To benefit from counseling,” they say, “a woman must admit that she needs help, must rely on the counselor and must openly discuss and express emotion. These requirements conflict with traditional ideals of what it means to be female: toughness, independence, and emotional control.”

What they appear to be saying is that womanhood itself is an obstacle to psychotherapy. At the very least, they see feminine strength and feminine values as antithetical to good mental health.

Let’s see a mental health professional try that kind of bigotry on men and see what happens to their career.

Their point, as unlikely and incredible as it may seem, is that women must learn to articulate feelings in a more masculine way and present them on demand for an hourly fee for the convenience of the therapist in her or his office. This is madness and an abusive form of it.

In the Everyday Health article, Dr. Amit Anand notes, “that it can be difficult to convince some women to try talk therapy.” I speculate that the reason for this is that women are not stupid. Talk therapy, as most commonly practiced, is a hard sell to women in the same way it is hard to sell them on astrology and the power of crystals.

The shame here is that while most of these supposed professionals demonstrate a lot of expertise on the political and ideological definition of women, they know little to nothing about real life, living and breathing women as they actually are.

This deficit in understanding is likely the main cause for the thinly veiled condescension that permeates their perspective. They are just talk about, not to, a population that does not trust them, and for good reason.

There will be much more on this, and some practicable solutions, in the not too distant future. I have begun a book that will almost certainly be published under the same title as this article. I hope to have it completed and out in advance of the next International Conference on Women’s Issues in Gold Coast, Australia next June.


Also, I am ending this with an announcement and in invitation for you to join An Ear for Women Forums.

The forum is designed to give women, all women and only women, a place to gather and talk about the issues they face in life. It is for single women, married women, estranged mothers and mothers who are raising their children. It is also for women in the dating scene and for those who have sworn off men altogether.

Unlike A Voice for Women, it is not an activist site. It is not about women’s rights at all, but about women’s well-being. Like all forums, it will start slow. So, if you are interested in helping us build a community where women can talk about issues, in whatever way they want to talk about them, please visit, register and introduce yourself to the group that is already there.