But I am also heartened by the private work that men are doing in therapy and how it can help us understand the relationship between what has been called “toxic masculinity” and the reservoirs of shame that fuel these behaviors.

I began to feel the effect in my work not long after the stories about Harvey Weinstein broke, with a noticeable uptick after a report on the comedian Aziz Ansari. Though the accusations against famous men were in one sense far from the people I saw, they were relevant to the questions they often brought to therapy. Why did they so misunderstand the women in their lives? Why were they often being accused of hurting them?

One man, a third-year medical resident, told me he saw himself in Mr. Ansari. Friendly but shy, he yearned to find a meaningful relationship but struggled to connect with women. He’d been experimenting with approaching women in a more “dominant” and assertive way, since he’d heard that’s what women wanted. He had made an aggressive move on a prospective date and was told that his approach was creepy.

Sitting on my couch, he could barely look me in the eyes. He confessed that he’d spent much of the weekend just lying in bed. He eventually acknowledged that he had been so focused on performing for dates that he wasn’t really connecting to them, unable to accurately read his date’s reactions. He was focused on tuning out his own discomfort and was unaware of the feelings of the woman in front of him.

The majority of men who enter my office appear either flat and emotionless or superficially engaged but hiding behind impenetrable niceness. When I ask a man, for example, how he feels when his girlfriend says, “I’m so upset, I can’t even be around you right now,” I usually get an answer like “It’s frustrating.” That’s a word that is used a lot yet conveys essentially nothing. Most men have spent little time with their feelings and have very limited vocabulary to describe what is going on in their hearts.