He had been a senior engineer at a major company for eleven years. He had survived three rounds of layoffs, led two successful product launches, and built a team that consistently shipped on time. By every external measure, he was doing well.
But he had not slept through the night in eight months. His wife had started asking, with increasing frequency, whether he was okay. He had started to wonder the same thing.
He reached out on a Tuesday afternoon, from his home office in San Jose, during a gap between meetings. He was not in crisis. He was not falling apart. He was simply tired of carrying something he could not name.
He is not unusual. He is, in many ways, representative of a shift I have been watching in the men who reach out to me from the South Bay and Silicon Valley corridor.
The Silicon Valley context is particular.
The culture of the tech industry has, for decades, organized itself around a specific kind of masculine ideal: the man who is productive, self-sufficient, and emotionally regulated. The man who ships. The man who leads. The man who does not let his inner life interfere with his output.
This framework is not entirely wrong. It produces men who are highly capable, who can hold complexity, who can sustain effort over long periods. But it also produces men who have learned to treat their inner life as a problem to be managed rather than a signal to be understood. And at some point — usually in the late thirties or forties, often after a significant disruption — the management strategy stops working.
The disruption can take many forms. A layoff. A promotion that felt hollow. A marriage that has quietly deteriorated while he was focused on work. A body that has started signaling, through anxiety or insomnia or chronic tension, that something has been suppressed for too long.
The man who has spent twenty years treating his inner life as a problem to be managed eventually discovers that the problem has not gone away. It has simply been waiting.
What has changed in 2026.
The men reaching out to me from San Jose in 2026 are different from the men who reached out five years ago. They are more willing to name what they are carrying. They are less likely to frame the conversation as a last resort. They are more likely to say, simply: I think I need to talk to someone, and I want to do it before things get worse.
Part of this is the normalization of virtual therapy. The pandemic forced millions of people into the online format and demonstrated, empirically, that the work could be done. Men who would never have walked into a therapist's office in their building discovered that the same work, conducted from their home office, felt accessible in a way that in-person therapy had not.
Part of it is the disruption of the tech industry itself. The layoffs of 2022 and 2023 shook the identity of men who had organized their sense of worth entirely around their professional role. When the role was removed — or threatened — the question that had been running in the background for years became impossible to ignore: who am I if I am not this?
And part of it is simply the accumulation of years. Men in their late thirties and forties have often spent long enough carrying something that they have run out of strategies for managing it. The thing that worked at twenty-five — the work, the gym, the next project, the next goal — no longer provides the same relief. The signal has become too loud to ignore.
The wound underneath the presenting problem.
In my clinical work, I use a framework called Life Telling Processing. The premise is that most of what a man brings to therapy — the anxiety, the relationship difficulty, the professional dissatisfaction, the sense of being stuck — is not the primary problem. It is the signal of a deeper wound that has been shaping the patterns of his life, often since childhood, without his awareness.
In the Silicon Valley context, the wound I encounter most frequently is what I call the Sovereign wound: the wound of the man who learned, early, that his worth was conditional on his output. This is not a wound that announces itself. It looks, from the outside, like ambition. It looks like drive. It looks like the qualities that built the industry. But underneath the drive is a belief that is not chosen — it is installed — and that belief is: I am only as valuable as what I produce.
The Sovereign wound does not become visible when things are going well. It becomes visible when the production machine slows. When the layoff happens. When the promotion does not feel like enough. When the man reaches the goal he has been working toward for a decade and finds, in the silence that follows, that the question he was trying to answer with the achievement is still there, unanswered.
What the work actually looks like.
The man who reached out from San Jose — the engineer who had not slept through the night in eight months — did not need to be fixed. He needed to be understood. He needed someone to help him locate the story underneath the insomnia, to trace the thread from the 3:00 AM wakefulness back to the belief that had been organizing his life since he was twelve years old and learned that his father's approval was contingent on his performance.
That is not a quick process. It is not a ten-session protocol. It is a sustained engagement with the narrative of a man's life, conducted by a clinician who is willing to go where the story actually leads. But it is also not indefinite. Men who do this work tend to move through it with a kind of focused intensity that is consistent with the way they approach other complex problems. They are not afraid of hard work. They are afraid of work that does not have a clear output. The work of therapy, when it is framed correctly, has a very clear output: a man who understands his own story well enough to choose, for the first time, how it continues.
A note on the virtual format for men in San Jose.
I work entirely virtually, with men throughout California. For men in San Jose and the South Bay, this means the session happens wherever you are — your home office, your car, a quiet room you have chosen. There is no commute. There is no parking. There is no building where someone might see you walking in.
For many men, this is not a minor convenience. It is the thing that makes beginning possible at all. The research is clear that virtual therapy produces outcomes equivalent to in-person therapy. The relationship is not a function of the room. It is a function of the quality of attention.
If you are a man in San Jose who is carrying something that has not yet been named, I want to invite you to consider that the hesitation you feel about reaching out is itself worth examining. The belief that you should be able to handle this on your own is not a character trait. It is a wound. And it is one of the things we would work on together.