Frank Ghinassi has spent four decades working in behavioral health. And he’s noticed a pattern that runs counter to what most people assume.
The most accomplished men he’s worked with — the ones with the advanced degrees, the corner offices, the resumes that make other people nervous — are very often the ones most convinced that the whole thing is one day going to fall apart.
Ghinassi, who serves as Senior Vice President for Behavioral Health and Addictions at RWJBarnabas Health and CEO of Rutgers University Behavioral Health Care, said he’s watched the pattern hold up for years.
“Imposter syndrome often ranks the highest with people who are the most accomplished and the brightest,” he said. “There’s this sort of unspoken fear that one day people are going to figure out, ‘I’m not that good. It’s just a matter of time before they realize it’s all been a show.’”
It’s one thread in a larger pattern Ghinassi has spent his career studying: the specific ways men experience — and hide — psychological distress.
Ghinassi, who also chairs the Board of Trustees for the National Association for Behavioral Healthcare, spoke with BINJE about what he sees and hears from men across generations. And why so much of it stays unspoken.
Here’s more of the conversation, edited slightly for length and readability.
BINJE: Let’s start with the view from 10,000 feet. What’s something about men’s behavioral health that the average person doesn’t realize, or needs to know more about?
FG: Probably stigma. When people study men’s mental health, one consistent finding is that men overvalue the impact of stigma — they’re very worried about being seen as weak or inadequate. Having sad or unpleasant or depressive feelings, in and of itself, feels like a sign of weakness they should be able to handle, which makes it harder to seek help, because seeking help is an acknowledgment that they can’t quite do it on their own.
So, acknowledging pressure, acknowledging distress, acknowledging internal psychological pain is stigmatized for a lot of men. And it creates a kind of compounding effect — not only are you feeling it, but now you feel bad that you’re feeling it.
BINJE: That sounds like a lot of stress. And understandably so. Many men are often seen as needing to be the provider, the caregiver, the husband — but never allowed to say, “this is tough.” How tough is that on men?
FG: Very. And it has real consequences. It’s a sad truth that men die by suicide at about twice the rate of women, and there’s a lot of literature on that globally, not just in the U.S. Yet of all the people who experience depression, only a portion of men who experience it have ever talked to anybody about it, where the rates are notably higher for women.
There’s a gap between experiencing it and getting help for it. I think it applies to pressure as well. Part of the expectation around being a man is that you’re supposed to experience the pressure and deal with it. It’s not supposed to be something you seek relief from — or complain about. There’s a real expectation that it’s part of your duty.
BINJE: Part of your work is getting men to talk about these issues. How do you do that?
FG: The challenge is creating a space in which resilience and strength is defined not by avoiding feelings, but by being able to acknowledge and express them. We try to create a situation where expressing those ideas is seen as another manifestation of self-care or strength.
Men are very often told they have to take care of business — so we try to help them understand that just like they go to the gym to take care of their physical shape, dealing with emotional distress that can lead to depression or reliance on substances is its own form of resilience and strength. We try to link self-care and self-identification with those ideas of resilience and psychological strength, and that’s sometimes a door opener for people.
BINJE: Some of the biggest leaders would reportedly relish the opportunity to step away from the spotlight — to step away from a scenario where they are the main focus of attention. Is that true?
FG: Absolutely. They can be the CEO of a company and wish: “I don’t want to be in charge of everything. I just want to be the average Joe, or I just want to be by myself.”
BINJE: Hats off to you if you can get men to share those types of thoughts — thoughts we’re guessing they’ve never shared with anyone, including their spouse. Is that common?
FG: Men often talk to other men about events, about cars, about sports — but it often isn’t about feelings. It’s changing, but I still think self-disclosure ends up being kind of a generational thing.
For what you’d think of as the remnants of the baby boomer generation — folks who are now really moving into retirement age and beyond — there really was a predominant stoicism. The idea that you’d share feelings with people was less common.
So, I think that’s probably an accurate statement for men of a generation or two ago. But we are seeing a little more in the last couple of cohorts of generations.
BINJE: Well, that’s great for this generation. But then there is this: This generation is dealing with something Baby Boomers never did — loneliness. Is this epidemic as bad as we hear?
FG: Yes. Studies show about 17 to 18 percent of this younger generation often endorsing this idea that they feel lonely. A lot of this stems from the time spent on social media and social platforms, where many hours are spent with eyes on a screen instead of interacting with people. It’s not just true of young men, it’s true of young women, too.
I’m always shocked when I go out to dinner and I’ll see two people at a table — maybe it’s a couple — and for minutes at a time they’re both on their phone. It would be like, in the old days, two people going to dinner and both of them have a newspaper up in front of them. It’s a very interesting phenomenon.
BINJE: And not a very healthy one.
For information about RWJBarnabas Health, go to rwjbh.org/.
