I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression (2011) by Terrence Real

Terrence Real weaves together anecdotes from his own personal experience with a conglomeration of his patients all supported by clinical theory and insight to exemplify the complex presentation of depression in men. By focusing on “overt” and “covert” forms of depression, Real goes on to home in on discerning how the presentation of depression in men can compare with presentations in women and mirror the DSM diagnostic criteria (Diagnostic and Statistical Manual, 4th Ed–because this book was published in 2011), versus how it can differ by presenting outwardly disguised as rage, violence, aggression, addiction, and workaholism. 

One of the main themes throughout my graduate education was that the answer to a majority of questions was “it depends”. There are numerous factors that contribute to our experiences and mental health conditions. Not only does Real focus on individual examples of various presentations, but he then puts them in the context of family systems and cultural context to further exemplify the bio-psycho-social-spiritual components of the development and presentation of overt and covert forms of depression in men, especially how patriarchal social structures shape the expectations around male-ness and how depression can be passed from father to son (as a legacy), as well as how it can be treated and healed effectively (thereby ending generational transmission). 

How was this book recommended to me? If I remember correctly, Dr. Gabor Maté referenced it in Myth of Normal. 

Would I recommend this to my colleagues? Definitely. 

Would I recommend this to my clients? Yes. 

How do I apply this content to my work: I work with both male and female clients who present to me seeking treatment for trauma and addiction. If a client comes to with symptoms of depression and/or anxiety, I can often link that with trauma (often accompanied by different forms of addiction). But as a woman treating male clients, there’s a lot I will never be able to resonate with. This book provided helpful insights that I might not have ever been able to identify. It was helpful for me to read this book and see the presentations of many of my clients (as well as other men in my life) exemplified in the characters in this book. And while my practice leans heavily into treatment of trauma and addiction, it reminds me how important it can be to also face the Depression and treat it directly whether it’s a symptom of trauma or the primary diagnosis.