Podcast Summary: "Do Men Really Need Therapy? Let’s Talk About It"

Compassion in a T-Shirt with Dr. Stan Steindl
Guest: Dr. Audra Horney
Date: November 7, 2025

Episode Overview

This episode explores the intersection of men's mental health, therapy, and compassion. Dr. Stan Steindl welcomes Dr. Audra Horney—a psychologist specializing in therapy for men—to discuss why men are often reluctant to seek help, how therapy can be made safer and more inviting for men, and the particular challenges and misconceptions men face around compassion and emotional expression. The conversation is rich with clinical insights, memorable anecdotes, and practical strategies for therapists and men alike.

Key Discussion Points & Insights

1. What Drew Dr. Horney to Men's Mental Health

• Dr. Horney’s Motivation: Specializing in men’s mental health was not her original plan but grew from her experiences in inclusive and culturally-informed environments and seeing a gap in care for men.
• Quote:
  • "It's genuinely the work that found me… I believe that we all deserve inclusive, culturally informed spaces for therapy. And unfortunately, I believe that's significantly lacking for men." [03:00]

2. The Need for Safe Therapeutic Spaces for Men

• Men's State Today: Many men crave connection and support but don’t know where or how to find it.
• Therapy as a Safe Container: Therapy offers the rare chance for men to "be messy, to be inarticulate, to be confused, to be angry… to say that they're struggling." [03:43]
• Barriers & Therapist Responsibility: Dr. Horney emphasizes that safety in therapy isn't always a given, and therapists must actively market and create their spaces to include men.
• Quote:
  • "I don't believe we can responsibly shame men for not going to therapy if therapists aren't doing our part to make sure that therapy is marketed as a space inclusive of men." [05:28]

3. Designing Spaces and Brand to Welcome Men

• Authenticity Matters: Authentic branding—from website copy to office decor—is vital.
• Memorable Moment: Dr. Horney has Teddy Roosevelt's "Man in the Arena" quote engraved in her waiting room to signal courage and effort, not perfection.
• Quote:
  • "It's the first thing men see when they walk into my office… Let's not fault the man in the arena with the dirt on his face and the blood on his hands. Like, he's the one working so hard… that's where the growth happens." [08:31]
• Consistency Across Mediums: The need for congruence between how a therapist presents themselves online and in person, to build trust before and after sessions. [13:00]

4. Humor as Connection, Not Deflection

• Reframing Humor: Against the view of humor as merely a defense, Dr. Horney finds it adaptive, soothing, and a point of connection, particularly for men.
• Quote:
  • "Sometimes the funniest moments… are in the midst of the darkest, hardest moments… humor is an opportunity to get your head up above water and take a deep breath before we submerge again." [16:34]

5. Navigating Compassion and Self-Compassion with Men

• Compassion Is 'Loaded’: The language of compassion (and especially self-compassion) can be off-putting to some men, often interpreted as weakness or self-pity. [19:18]
• Alternative Approach: Dr. Horney uses parts work (IFS) and indirect routes—inviting men to reflect on their younger selves or children—to help them recognize deservingness of compassion.
• Societal Context: Men are often socialized away from receiving empathy or validation, and it can feel especially uncomfortable coming from a female therapist. [24:09]
• Quote:
  • "If I go sort of heavy handed directly into self-compassion without setting the stage, I can… found that men will often try to almost push that away. Like that's not for me." [21:55]

6. Building Emotional Vocabulary & De-Shaming Feelings

• Tools: Dr. Horney employs Mark Brackett's "emotion grid" to aid men in naming emotions, preferring it over emotion wheels due to its clarity of experience.
• Normalizing Suppression: Many men were only permitted to feel ‘fine,’ ‘angry,’ or ‘numb’ and need gentle psychoeducation to develop more nuance. [27:20]
• Science as Leverage:
  • "Studies have shown that baby boys are more emotionally expressive than baby girls, but we socialize that out of them after a few years." [29:39]

7. Sadness, Shame, and Courage

• Sadness & Vulnerability: Men often find sadness particularly hard to access—layers of numbness, protectors, and fears of emotional ‘collapse’ get in the way.
• Shame as a Gateway: Naming shame is often more resonant for men than directly discussing sadness. [31:41]
• Role of the Therapist:
  • "My job is not to get men to cry in my office. It's about helping them tap into their honest, true, authentic selves… with patience and curiosity and compassion." [33:08]

8. The Inner Critic and Self-Criticism

• Motivator—or Saboteur?: Many men use harsh self-criticism as self-motivation, but Dr. Horney gently exposes its ineffectiveness (e.g., "You're on my couch right now, buddy. If it were working, don't you think it would have worked by now?") [35:39]
• Using Logic, Not Just Emotion: Asking men if they would motivate their kids this way helps expose double-standards and fosters self-reflection.
• Quote:
  • "The goal here is to be more curious than critical… Instead of asking yourself, 'Why the fuck do I do that?' ask yourself, 'Huh, why do I do that?' Just the tiniest little shift." [39:44]

9. Shame vs. Guilt

• Psychoeducation: Dr. Horney distinguishes shame (“I am bad”) from guilt (“I did something bad”—a misalignment with values), using Brene Brown’s research as a framework. [42:04]
• Antidotes: Dialogue and empathy help break cycles of shame and move toward growth, honesty, and alignment with core values.

10. Expanding Masculinity and Compassion

• Breaking the "Man Box”: Dr. Horney yearns for a world where men are permitted to be dynamic—assertive but also compassionate, gentle, vulnerable.
• Quote:
  • "It can be masculine to be compassionate. It can be a form of healthy, authentic masculinity to love deeply, passionately, and publicly. We have put such a limit on what masculinity is allowed to be."[49:30]
• Call for Cultural Change: Permission for boys and men to "exist more fully and honestly" could greatly advance both well-being and authenticity. [51:54]

Notable Quotes (with Timestamps)

• On Therapy for Men:
  "Men are not all right. And they, I believe, are really desperately craving connection and support and to be known and to be seen and not always knowing where to find that." — Dr. Audra Horney [03:43]

• On Authenticity:
  "If I'm not showing up authentically and professionally and ethically, of course, but authentically. And I'm asking him to, like, what a fucking fraud. Like that, that seems so unfair and it seems so unproductive in my opinion." — Dr. Audra Horney [09:31]

• On Reluctance to Use the Word 'Compassion':
  "I have found that if I go sort of heavy handed directly into self-compassion without setting the stage, men will often try to almost push that away. Like that's not for me… I don't want your pity. I don't want to pity myself. That's just me settling." — Dr. Audra Horney [21:55]

• On Self-Criticism:
  "So many men are suffering in silence and so many men have… the most awful things to themselves and think that's just the way it is… I'm often telling my clients, the goal here is to be more curious than critical." — Dr. Audra Horney [39:44]

• On Expanding Masculinity:
  "It can be masculine to be compassionate and it can be a form of healthy, authentic masculinity to love deeply and passionately and publicly." — Dr. Audra Horney [49:30]

Timestamps for Important Segments

• [01:32] – Dr. Horney describes her entry into men's mental health
• [03:43] – On what men seek in therapy and the unique safety it can provide
• [07:13] – Designing physical & digital therapy spaces to be inviting for men
• [09:31] – Importance of therapist authenticity and boundaries
• [15:58] – Humor in therapy: its adaptive and connecting function
• [19:18] – Men’s resistance to "compassion" and adjustments in language
• [26:59] – Building emotional vocabulary: strategies and tools
• [31:41] – Accessing and working through sadness and shame with men
• [35:39] – Addressing self-criticism, using logic and humor
• [42:04] – Psychoeducation: Guilt vs. Shame and their functions
• [49:30] – Expanding the definition of masculinity and permission for emotionality

Memorable Moments

• Man in the Arena Quote: The Roosevelt quote in Dr. Horney's waiting room becomes a powerful visual anchor for clients, representing bravery in seeking help and engaging with vulnerability. [08:31]
• "You're on my couch right now, buddy.": Horney’s humorous approach softens a challenging truth about the limits of self-criticism as motivation. [35:39]
• Humor in Dark Moments: Shared laughter with clients in the midst of pain becomes both a coping tool and a bonding agent. [16:34]

What's Next for Dr. Horney

• New Podcast:
  Dr. Horney is launching "This Triggers Me" with Dr. Brendan Kwikowski Hartman in early 2026, tackling polarizing topics and showing real, messy, triggered professional conversations—modeling regulated disagreement and deeper understanding.
  • "It's about leaning in to our triggers and not avoiding those difficult conversations." [54:11]

Final Takeaway

This episode offers a nuanced, compassionate roadmap for clinicians and anyone concerned with men's well-being. Dr. Horney’s approach—rooted in authenticity, relationship, humor, indirect compassion, and psychoeducation—illuminates new ways of making therapy genuinely accessible, meaningful, and life-changing for men.