Why Others Need Therapy — But I’m Fine

Nick Holt is a licensed clinical social worker and certified CBT therapist in West Los Angeles, CA.

You’ve recommended therapy to at least one person in your life. Maybe more. You saw what they were carrying and you said, without hesitation, that talking to someone would help.

You meant it. You were probably right.

And yet here you are.

The most common reason high-functioning men don’t get help isn’t that they don’t believe in therapy. It’s that they’ve quietly exempted themselves from needing it.

The argument usually goes something like this: Things are hard, but I’m managing. Other people have it worse. I’m not in crisis. I know what my issues are. I just need to push through.

Every part of that can be true and still be a problem.

The Heroes Myth
I spent years working with veterans. The ones who hadn’t served abroad would tell me: I don’t need help — take care of the guys who were actually deployed. The deployed veterans would say: I was in support — help the guys who were out on the FOB. The guys on the FOB would say: I’m no hero, help the special ops guys — those are the real heroes. And when I met with special ops, they’d say: I’m no hero. The only real heroes are in the ground.

The exemption logic doesn’t stop. It just keeps finding someone more deserving until there’s no one left.

Most men who don’t seek help aren’t using the word “hero.” But the structure is identical. There’s always someone who had it harder, sacrificed more, has a better reason to struggle. You will never be the person who qualifies enough. That bar doesn’t exist — it just keeps moving.

The question was never whether someone else has it worse. It’s what staying the same is costing you.

Being Good at Things Isn’t the Same as Being Okay
Competence is convincing. If you’re reliable at work, present for the people around you, and good at holding it together under pressure — that looks like evidence that nothing is wrong. It isn’t. For a lot of men, that performance is exactly the thing that needs examining. Not because it’s fake, but because it’s exhausting, and because somewhere underneath it is a person who’s been running on empty for longer than he’d admit.

You Take Care of Others. That Exempts You from Nothing.
Men who carry responsibility for other people — as fathers, partners, professionals, caretakers — often develop an implicit belief that needing help is for the people they help. They’re the ones who hold things together. Needing support feels like a category error. It isn’t. It’s just what you’ve told yourself long enough that it stopped feeling like a story and started feeling like a fact.

Understanding Isn’t Changing
This one is specific to men who are smart and self-aware — which is most of the men who end up in my office. They’ve read the books. They know their patterns. They can describe their childhood and its likely effects with impressive clinical detachment. And they’re still doing the same things they’ve always done.

Insight is not the same as change. Knowing why you avoid something doesn’t make you stop avoiding it. That’s not a character flaw — it’s how behavior actually works. The knowing and the changing are different problems, and one doesn’t automatically solve the other.

If any of this is landing, it’s probably not because your situation is unique. It’s because these patterns are remarkably consistent — in men who are otherwise very different from each other. Which is the point.

You don’t need to be in crisis to deserve help. You just have to be tired of things staying the same.


Nick Holt is an LCSW and A-CBT Diplomate in private practice on the Westside of Los Angeles. He has spent over a decade as a social worker serving LA County’s most forgotten and most impaired — the people the system failed repeatedly. He has also been a son watching his mother through a long and difficult end, a father, a surfer, a drummer, and someone who has broken his neck and come back from surgical repair of his shoulder. He knows what it takes to keep moving. He also knows what it costs to never stop. Carving out space for his own psychotherapy has been critical to his growth — not as a therapist, but as a person. He works with men, caregivers, and high-functioning individuals who are ready to do the same. Free consultations at nickholtlcsw.com.