Masculinity as a current request in Psychotherapy

Abstract

Introduction: amidst the transformation of social structure, shifting gender roles, and the erosion of traditional notions of «male purpose», a phenomenon known as a «masculinity crisis» is emerging. Despite men's growing need for psychological support, their rate of seeking help remains significantly lower than that of women, and existing psychotherapeutic services are predominantly targeted at women. The purpose of this article is to systematize data on men's requests for psychotherapy, analyze the intrapersonal mechanisms underlying the development of distorted masculinity, and identify therapeutic strategies for addressing masculine needs. Materials and Methods: the study is based on a review of contemporary Russian and international scientific works on male identity (2011–2025) and an analysis of statistical data on psychological support requests in the Russian Federation for 2024–2026 (Russian Red Cross, VSK Insurance House, the «Yasno» service, and the "Direct Dialogue" helpline), as well as the author's clinical observations in his psychotherapeutic practice (2018–2026). Literature review and synthesis, statistical analysis of visits, and content analysis of sessions were used. Results: a steady increase in the proportion of men among psychotherapy clients was recorded: over the past four years, this figure increased by 10%, reaching 32%. The most active age group for requests is men aged 36–50, experiencing a reassessment of their values. Key themes of requests were identified: couple relationships (26%), loneliness and loss of meaning in life (21%), and depression and anxiety (approximately 30% combined). Significant changes in social notions of masculinity, as well as transformations in behavioral patterns and presentations of masculinity, are observed across generations. This is particularly pronounced among younger cohorts, who demonstrate a declining centrality of gender identity to their sense of self. A distinction is made between adaptation crises (reactive, related to specific events) and existential crises (meaning of life and identity crisis). Distortions of masculinity are rooted in conflicts of identification with the father, disrupted separation from the mother, internalized early parental injunctions, and psychological trauma. It is substantiated that men more often somatize psychological distress, which creates additional barriers to timely psychotherapeutic assistance. Discussion and Conclusion: the findings refute the thesis about the «lack of a culture of men seeking psychological help». Rather, the problem lies in the shortage of accessible, gender-sensitive, and socially accepted forms of psychological support. When working with younger generations, practicing therapists must consider shifts in the perception of the masculine role: the declining centrality of gender identity, distancing from traditional masculine norms, and a demand for hybrid models of masculinity that combine instrumental and expressive characteristics. Promising approaches include the development of specialized men's psychological programs and support groups, information campaigns through male communication channels, and training primary care physicians in recognizing the psychogenic etiology of somatic symptoms in men. Effective therapy for masculine needs should include working through separation from the maternal figure, developing emotional intelligence, working with the paternal figure, existentially exploring meanings and values, and developing a new, multidimensional masculine identity.