糖心官网

I remember where I was when I got the call that a friend of mine had died by suicide. I held the phone in one hand while my other hand traced the brickwork of the building I was staring at. I remember the waves of anger I felt as the caller described what happened, followed by shame for feeling angry, then disbelief, and finally numbness. I pictured him in his final state, lifeless 鈥� so unnatural compared to his dynamic, very much alive self.

This cycle 鈥� from anger to shame to numbness and back again 鈥� has been with me while writing this article. It is alive in other parts of my life too. Sometimes I scroll back to the last text my friend sent me in 2018. He asked about a shared hobby of ours, then signed off with a crude insult, intended fondly. I did not reply. Sometimes I found him difficult, and I can imagine myself in a hurry, possibly irritated by his crudeness, thinking, I鈥檒l get back to him later. But I never did. Oh, the shame聽

I鈥檓 conscious that you, reader, may also be a therapist who has been impacted by suicide (a suicide survivor). If a client dies by suicide, this can be profoundly impactful. By nature, we build deep relationships with our clients while holding professional distance and boundaries at the same time. This is a position of contradictions, which we hold delicately through ethical frameworks, self-reflection and supervision. A suicide can blow this balance wide open and lead to a double聽sense of shame: professional shame due to our clinical responsibility for our clients, and shame as a human being in a relationship with another human being. We can find ourselves feeling like we were not enough to keep this person alive. Perhaps for the first time, our therapy room becomes akin to an emergency room or operating theatre: where before they were neutral, good-enough spaces to contain emotions, they now become spaces in which the battle of life and death has taken place. Whatever the topic of suicide means to you, it is one, along with shame, that can be deeply affecting, and as such I invite you to take care of yourself while reading this article.

Beyond the statistics聽

Based on my experience, shame is both so difficult and so commonplace among men that it would not be uncommon to work with a man who has not at some point considered suicide due to shame, though the seriousness of this consideration may vary widely. For some men, it takes the form of a fleeting thought when shame is activated (the French describe this as l鈥檃ppel du vide, or 鈥榯he call of the void鈥�: a sudden, unsettling urge to do something dangerous, like the Thanatos-related impulse to jump from a height or in front of a train). For other men, it takes the form of a prolonged and distressing preoccupation, which can carry a higher risk level. Whichever end of the scale a man鈥檚 suicidal ideation may fall, I believe that it is there with him in the therapy room, often hidden 鈥� or indeed activated by 鈥� shame.聽

I began researching this article with a review of current UK suicide data. Suicide is one of those topics for which statistics are widely circulated, and I found that they indicate suicide affects more men than women, and men in their 50s are among those at highest risk.¹ More anecdotally, I sense that the stigma attached to suicide has shifted. In the wake of actor Robin Williams鈥� death by suicide in 2014, for example, several public figures posted uninformed and insensitive opinion pieces and tweets describing it as a selfish act. Though such remarks met with pushback at the time, it seems fewer people in 2026 are inclined to frame suicide this way, and there鈥檚 a growing recognition of suicide as the result of illness rather than some personal failing or weakness.聽

Despite widely known statistics and shifting cultural attitudes, however, often conversations about suicide still lack nuance. I was certainly not prepared during my research for some of the realities I found behind the headline figures. For example, in the Office for National Statistics (ONS) breakdown of suicides recorded in the UK, the age categories begin at 10 to 14 years old. I write this after spending a weekend with the 10 and 11-year-old children of a friend, and it feels unfathomable to me that the data begin with children that age. Yet the ONS reports that 27 boys aged 10 to 14 died by suicide between 2022 and 2024. Another difficult truth is that, despite huge public campaigns, the male suicide rate rose slightly in 2024, with 17.6 suicide deaths per 100,000, compared to 17.4 in 2023.¹ This demonstrates the urgency of the crisis: regardless of even a widespread anti-suicide campaign, male suicide rates seem not to be falling.聽

鈥楲ife is tough, but so are you鈥櫬�

No single pathway leads men to suicide. However, men鈥檚 traditional social roles and expectations appear to be at least partially influential factors. Importantly, these influences are not always inherently bad, but they may still cause feelings of shame for some men. For example, in 2025, a well-known national men鈥檚 charity that promotes group-based support, launched a new public campaign, advertising on bus stops and posters throughout the UK with their slogan: 鈥楲ife is tough, but so are you.鈥櫬�

I cannot know how this message landed for every man who encountered it 鈥� men are often framed as a monolith, something I wish to avoid. It no doubt galvanised resilience in many men, and I trust the charity to know what they鈥檙e doing and how the campaign would come across. But for some men 鈥� particularly those who already feel they cannot cope or are worn down by the pressures of masculinity, fatherhood, work, and patriarchal responsibility 鈥� this well-meaning slogan may inadvertently reinforce a sense of shame at not feeling what men are so often told they should be: tough. What if I cannot 鈥� or do not want to be 鈥� tough?聽

Many mental health campaigns keep their message simple with variations on 鈥榦pen up鈥� or 鈥榯alk to a mate鈥�. Again, these are well-intentioned, but the danger is that they can seem to assume that all men possess the mental health literacy required to articulate complex feelings, such as shame or suicidality. If only they could be given permission to speak aloud their troubles, these campaigns might suggest, men could talk themselves better. However, my experience suggests that many men lack the tools to discuss societal expectations, shame and suicidal ideation (or to listen if a friend does open up about such things). I believe they require more than mere permission to speak. In fact, encouraging them to do so in these ways may activate shame in some.聽

To be clear, the importance of men talking about their issues cannot be underestimated. I do not want to be critical of campaigns that promote potentially life-saving interventions. However, I do want to highlight that shame so often stands in the way of men asking for help, and that exhorting men to 鈥榮peak up鈥� can, paradoxically, lead to further shaming. As Gilbert鈥檚² work highlights, 鈥榚xternal shame鈥� is shaped by the ways that individuals imagine others see them. For men, this shame can feel extremely self-conscious. Fear of judgment or exposure for seeking help by talking or opening up, makes it feel socially risky rather than relieving. Again, I stress that this is not about levelling criticism at any one campaign or overlooking or undervaluing the potential benefits of these campaigns. This is about drawing attention to what can get lost; that is the wider societal context that shapes men鈥檚 lives and their thoughts around suicide.聽

鈥楽top disappointing people鈥櫬�

If some men feel shame in response to the campaigns designed to support them, where does that leave us as mental health practitioners? I explored these issues with Nick Dunne, Director of the Global Community Men鈥檚 Health Programme at Movember. He has over 25 years鈥� experience in young people鈥檚 and men鈥檚 mental health, sexual health and therapeutic services. The programme delivers research-driven, scalable interventions that support boys鈥� and men鈥檚 emotional wellbeing, help-seeking and connection.聽

Nick sees men鈥檚 lack of mental health literacy in his work too, particularly when he discusses shame. 鈥榃hat鈥檚 striking,鈥� he tells me, 鈥榠s that the same pattern shows up in both one-to-one work and community programmes. Men talk around the issue without naming what鈥檚 actually going on, and that gap 鈥� the space where something important isn鈥檛 being said 鈥� is often where shame lives.鈥� He says that men present as 鈥榟igh-functioning 鈥� working, coping, and seeming fine in public鈥�, but privately feel stuck, behind or overwhelmed.聽

鈥楽hame is conspicuous in its absence,鈥� I offer, adding how much effort, both conscious and unconscious, must go into preserving that high-functioning state, considering how powerful shame can feel for some men. 鈥業鈥檒l give you an example,鈥� says Nick. 鈥業 once worked with a father who talked about suicidal thoughts. He didn鈥檛 say he felt ashamed; what he said was, 鈥淢y kids would be better off if they didn鈥檛 have to see me like this.鈥� The shame was in how he imagined he was being seen. Shame, hopelessness and isolation build on each other, and I think these trends absolutely shape men鈥檚 attitudes towards suicide.鈥櫬�

Nick鈥檚 example recalls Gilbert鈥檚 concept of external shame, seen here through the eyes of the father鈥檚 children. For this man at least, shame appears to feel deeply conspicuous. This feeds into my suspicion that, for some men, suicide can feel like a way to stop the overwhelming emotion of shame. Nick tells me, 鈥業 often hear men describe suicide not as a desire to die, but as a desire to stop disappointing people. When you explore this with them, it becomes clear how long it takes for the real feelings beneath the silence to emerge... men will often say, 鈥淚 could never tell my family or friends about this.鈥� So, shame isn鈥檛 just about the distress they feel; it鈥檚 also about the belief that talking about the distress is shameful.鈥櫬�

This makes me think about the mental health literacy campaigns encouraging men to 鈥榦pen up鈥�. At least in Nick鈥檚 (and my) work, opening up about distress isn鈥檛, itself, shameful, and I wonder what function the shame serves if it keeps these men silent. When a client expresses a repetitive belief or feeling, I often explore what they think its function might be. I might ask a client who can鈥檛 imagine sharing his shame with a loved one to imagine a second version of himself in the room with us: the shamed version who cannot open up about his distress. I may ask, 鈥業f we could ask this second version of you what he is trying to achieve by not talking to family or friends, what might he say?鈥� Often, what begins to emerge is not simply fear of judgment, but a deeper concern about moral exposure: a sense that speaking would confirm something unforgivable about who he is as a father, partner or man.聽

Given this fear of moral exposure, we can understand shame as serving a protective function against what Brett T Litz calls 鈥榤oral injury鈥�:³ the collapse of a person鈥檚 sense of themselves as fundamentally good, acceptable or worthy in the eyes of others. Taking the 鈥榮econd self鈥� approach to men鈥檚 shame, we can help them step back from the immediate intensity of their moral injury. Once they are removed from the discomfort of speaking directly about themselves, they may be open for more abstract reflection. By inviting clients to observe a second version of themselves, we give them an opportunity to describe what they see or imagine, thus slowly building mental health literacy and a language to describe themselves. For men who struggle especially with mental health literacy, I may simply ask, 鈥榃hat is this version of you wearing? Is he shaved? Is he standing straight or hunched over? Why do you see him that way?鈥櫬�

Conditional worth聽

Shame is relational in nature and often rooted in early familial wounds via parents and carers who are emotionally mistuned to the needs of the boys in their care. I ask whether, in his work, Nick sees men鈥檚 shame responses as keeping them from opening up to protect an earlier wound, and whether this influences suicide risk. 鈥業鈥檝e worked with men whose early experiences taught them that care was conditional. Later in life, this can present as perfectionism, emotional numbness, over responsibility or feeling not good enough. Common stressors like relationship breakdowns or financial strain can reactivate those childhood wounds. I worked with a young man who鈥檇 grown up with parents struggling with addiction; when he started experiencing debt as an adult, it triggered those early feelings of inadequacy.鈥櫬�

His answer reminds me of Rogers鈥� conditions of worth,⁴ the implicit and explicit rules we learn from caregivers, culture or other relationships about what makes us acceptable or lovable. I cannot help but connect this to how patriarchy affects parent-child dynamics and the many adaptive ways boys seek their father鈥檚 love, compared to their mother鈥檚. In these socialised roles, mothers are seen as nurturing, available, soft, and required to give unconditional love, whereas fatherly love is seen as conditional, according to patriarchal rules. As James Saslow discusses in the anthology The Man I Might Become: gay men write about their fathers:⁵ 鈥極nly mother love is unconditional鈥� But fatherly love is also about licking the child into shape... fathers challenge and then judge us 鈥� their role in socialising the next generation. In this mythic battle of wills, persuasion and example are the preferred weapons, but if they don鈥檛 work, the drill sergeant [the father] will have to unleash the A-bomb of familial warfare: rejection.鈥� This insight seems to anticipate exactly how many of the men Nick works with might internalise deep patterns of patriarchal, conditional self-worth, rejection and shame聽

Community of despair聽

Wondering about dynamics outside the family, I ask Nick whether wider determinants of health 鈥� social, intersectional or economic pressures 鈥� play a role in men鈥檚 suicidality. 鈥楨arly in my career,鈥� he says, 鈥業 didn鈥檛 fully appreciate how much social and economic stressors shape men鈥檚 mental health. In communities where manual work is central to masculine identity, mass unemployment can create a community of despair. When factories close, men lose not only income, but a sense of worth, purpose and continuity with previous generations.聽

鈥楢nd it鈥檚 not as simple as saying, 鈥淔ind another job鈥�, you might have decades-old community structures collapsing at once 鈥� insecure housing, poor health, no replacement employment. Masculinity is often tied to being productive, dependable, a provider. When that鈥檚 taken away, shame can flourish. We鈥檝e also seen spikes in suicide rates after mass redundancies 鈥� and yet, the response often focuses only on getting people back into work, rather than addressing the psychological impact.鈥櫬�

Nick talks about communities where generations of men 鈥� grandfathers, fathers and sons 鈥� all work for the same company. The roots of masculine self-worth that come from these jobs run deep within the community and in the blood. When they lose this through redundancies, for example, they lose themselves and their purpose. This reflection matches research which shows that work-related problems, particularly redundancy and unemployment, are known to be associated with suicidal behaviour,⁶ particularly in mid-life.聽

Nick鈥檚 use of the term 鈥榗ommunity of despair鈥� strikes me deeply. So often we 鈥� I include myself 鈥� speak of community as an antidote to shame, but Nick鈥檚 experience shows the inverse, the 鈥榰pside-down鈥� of a healing community, where suicide can appear to spread in a contagion-like pattern, lingering in the community鈥檚 collective despair, sustained, no doubt, in part by stigma and shame. Often, this can prevent members of certain communities from speaking openly about a suicide loss, thus limiting their access to support.^7听

In some cultural and religious contexts, suicide is considered a sin, prompting families to conceal it as a cause of death. The taboo of suicide is often kept as an open secret in this context, compounding shame and further preventing other community members from seeking help. Nick gives me several examples from his work in Birmingham and Liverpool, cities in the West Midlands and Northwest of England. At funerals for men who died by suicide in these communities, the cause of death is never discussed and is sometimes covered up with the explanation that the man 鈥榙ied in his sleep鈥�. In this way, shame lives on long after the man has died. It is held by his family members, groups and communities, never allowed into the light and perhaps never truly healed, preventing the next generation of men from seeking help.聽

This is an edited extract from a chapter titled 鈥楤eyond the Statistics: men and suicide鈥� by Jeremy Sachs in the forthcoming book, Clinical Perspectives on Working with Men and Shame (Routledge, 2026), edited by Jeremy Sachs. It is reproduced with kind permission of the publisher.聽