I don't want to talk about it ...

It's official: being a man is bad for your health. Could therapy help, asks Glenda Cooper

Long after the sexual revolution, equal rights and Lady Chatterley's Lover, women still do not understand how men feel about sex. And they are therefore damaging men's health. What men really need, according to Andrew Marshall, president of the British Men's Counselling Association, is to be able to confide in other men. In the late 20th century, we have made the mistake of thinking equality equals sameness, whereas men and women, he reminds us, remain very different.

Yes, says Mr Marshall, men still find it difficult to articulate their feelings. They treat therapy as a problem-solving exercise rather than a chance to take succour from empathy administered by a qualified stranger. And they freeze if called to discuss sex with a woman.There is, he feels, a way to change this - simply introduce more males into counselling, a field that has in the past been dominated by women. At present, only 15 per cent of Relate's counsellors - 300 out of 2,400 - are men.

An inability to communicate with your partner is not just embarrassing and somewhat lamentable. If you are male, the chances are that it is actually putting your health at risk as you internalise your stress and anxiety instead of confronting and discussing your problems. A recent report by the Royal College of Physicians and the Royal College of Psychiatrists estimated that 50 per cent of illnesses may have their basis in stress and anxiety.

"The link has been made between emotional and physical health," says Denise Knowles of Relate. "It has always been acknowledged that we need a certain amount of stress to function. But if you've got a problem with a relationship that needs to be dealt with and isn't, it all goes wrong.

"You start suffering from headaches, ulcers, lethargy. You may notice that you always seem to pick up what's going round. You never get colds, but you've had three in quick succession. We're seeing that more men now suffer from eating disorders. It can be dangerous for your health if you're not getting any help."

Sounds familiar? But many men continue to dismiss therapy. Nicholas Davidson, a 25-year-old solicitor, sums up the general feeling: "I don't think it does help particularly. If you are in a gay relationship, there isn't the commitment of kids and you're just looking after yourself.

"If a relationship doesn't make you happy, then leave. Don't start to examine your relationship with your mother and father. I don't agree with the looking-back element of therapy. It should deal with how to get on with what you have to face in the future."

Alan Woodward, a businessman in his thirties, tells a different story. He decided to go to a counsellor after his girlfriend suggested it. "I would bottle things up and then fly into huge (verbal) rages, usually at inappropriate times," he says. "Something small would happen and I would fly off the handle or sulk for days."

He was referred by a GP to a [female] counsellor. For the first time, he began to discuss his life. He had had an alcoholic mother who died when he was 10, a domineering father who flew into violent, uncontrolled rages, and at the age of nine he was sent away to boarding school.

"Talking to a counsellor has allowed me to understand for the first time my feelings of abandonment, of rejection, of fearing angry scenes because they remind me of my childhood, of lack of trust in people," he says. "Once I can do that, I can also begin to change how I behave. It may seem strange that what should be obvious to you needs a counsellor to bring them out."

But even if men start safeguarding their health by seeking counselling, their approach needs to be dramatically altered so that they do not leap from exploring a problem to taking action without trying to understand it first. Marshall categorises women's attitude to problems as "21st- century" but men's as "not quite caveman but certainly not post-industrial revolution".

How can talking to another man help? "Sex is a prime example of how men's and women's viewpoints are dramatically opposed. It is one of the few times when it is culturally acceptable for men to show their vulnerability and their nurturing side," says Mr Marshall.

"Men may be aching with their need to express love, but women interpret that as trying to get their end away. The problem is, men can't vocalise what they are feeling. They don't have the words. And that's where a male counsellor comes in because he understands what the man is failing to say and can help the client explain."

According to the clinical psychologist Oliver James, men feel anxious about whether they will be able to satisfy the woman and whether they will be able to sustain an erection; if they are young men, they often worry about premature ejaculation. Despite New Man's image as a caring and sharing individual in tune with his emotions, the inarticulate caveman, if Mr Marshall is to be believed, still lurks within. "We're on the edge of a revolution, but we haven't quite got there yet," he says.

Mr Woodward still cannot bring himself to tell people about his time in counselling: "Men are, I suspect, scared of discussing their feelings. The discussion itself is seen as a sign of weakness. The roots of this probably lie in the fact that such 'weakness', in a world where competitiveness and hardness are still seen as the ultimate in male attitudes, can and often does count against you."

It may be good to talk, but Bob Hoskins still has his work cut out to convince most men.

Some of the names have been changed