Ask your teenaged son how he is doing and you are likely to get a terse reply. “All right.” “Fine.” Or maybe, “I’m chillin’.” Though most young males are teeming jungles of thoughts and emotions, they seldom talk about their inner lives. Male reticence is often shrugged off as hormone poisoning, but if Harvard psychiatrist William S. Pollack is right, the hormone myth is just a story that we tell ourselves in order to avoid the hard and sometimes psychologically treacherous work of trying to get boys to tell us what’s going on in their hearts and minds.

In Real Boys’ Voices, a sequel to his best-selling Real Boys, Pollack and his associate Todd Shuster record their efforts to help young men find their voices on such topics as drugs, girls, bullying and abuse. Many pages resonate with fears, pains and resilient hopes that will have you shaking your head and blessing the strong and struggling kids trying to find their path in a world in which all roads seem to be shifting under their feet.

Pollack has spent much of his professional life trying to crack what he terms “the boy code”—that is, the silent injunction against self-expression. As one of the 13-year-olds whom Pollack interviewed put it, “Boys are supposed to shut up and take it, to keep it all in. It is harder for them to release or vent without feeling girly. And that can drive them to shoot themselves”—or someone else. As Pollock observes, male teenagers are responsible for a hefty portion of the violence in America, and that violence is perhaps best heard as an expression of their painful muteness.

Simply reading the measured and poignant soliloquies captured in this book is enough to render the reader a more patient, persistent and attuned student of the inner life of boys. While this is not a self-help book for parents, it includes a useful coda of concrete and practical suggestions for enhancing the prospects for conversation with that quiet but disquieting group of males.

Harrison Pope, Katharine Phillips and Robert Olivardia are concerned about males of all ages who are unhappy with the image they see in the mirror. If you worry about balding and the girth of your gut or spend too much time lifting weights or fretting about your diet, you may be suffering from what they call the “Adonis complex,” an “array of usually secret, but surprisingly common, body image concerns of boys and men.”

Since the late 1960s it has been widely acknowledged that many women suffer from the willowy standards of feminine beauty promulgated by Hollywood and the mass media; however, scant attention has been paid to the effects of contemporary masculine iconography on the male psyche. The rules of even watered-down machismo make it clear that men are not supposed to linger in front of the mirror or think and talk much about their appearance. Pope et al. argue that the image industry has been as destructive to men as to women, with one difference: “Women, over the years, have gradually learned—at least to some extent—how to confront society’s and the media’s impossible idea of beauty. . . . But men still labor under a societal taboo against expressing such feelings.”

The authors contend that over the past couple of decades the ideal male body has literally been put on steroids. Popular images of the perfect male portray an Adonis who keeps getting bigger and bigger. Exhibit A consists of a comparison of current GI Joe action figures with those of 1964. When this toy first hit the market, GI Joe had the equivalent of a 44-inch chest and 12-inch biceps. Joe must have been pumping iron since then, for the GI Joes sold today have the equivalent of a 55-inch chest and 27-inch biceps. And then there are the steroid-inflated men (some of whom have become governors) who fly across the screen in professional wrestling shows, action flicks and video games. According to The Adonis Complex, the only way that boys becoming men could begin to look like the gods they glimpse in movies and fitness magazines is to do what the Terminator did: take steroids. And that is precisely why an estimated one in 15 young men is either on or has taken anabolic steroids.

This book heaps much of the blame for rampant steroid use on professional image-makers. But it also faults the medical establishment for blathering away its credibility. Anyone who has ever been around such sports as football and track and field, or who has followed the trajectory of Mark McGuire’s physical growth and homerun production, knows that steroids dramatically enhance athletic performance. But as late as 2000, “in the Physicians Desk Guide, you’ll find statements such as ‘anabolic steroids have not been shown to enhance athletic ability.’” Worse yet, it took medical researchers years to acknowledge the obvious fact that steroids radically increase muscle growth. The Adonis Complex contains reports of steroid-using heavy-lifters gaining as much as 100 pounds of muscle. The medical community’s seeming ignorance has made it easy for young men to ignore its warnings about the health risks of illicit supplements.

Pope and his associates assert that while there are strong suspicions that steroid use poses serious long-term health risks, there is as yet no hard evidence. They are, however, unequivocal about the psychological effects of “juicing.” There is abundant and irrefutable evidence that the expression “roid rage” is rooted in reality. Severe and often tragic psychiatric problems such as paranoia and violent behavior often follow the use of the muscle-producing drugs.

The book presents many gruesome case histories as evidence. For example, a 14-year-old with no record of psychiatric problems started on regimes of steroids. Two years later, when he was “taking big doses of testosterone, plus a second anabolic steroid in pill form,” he learned that his girlfriend was cheating on him. He took a knife from his mother’s kitchen, “lured [his girlfriend] out with him into the nearby woods, and stabbed her many times.” Though it is often the last thing that investigators think of, steroids may inflate the violent crime rate as well as biceps.

In the research phase that preceded writing this book, the authors tacked signs in local gyms inviting men who were dissatisfied with the way they looked to come in and talk. To the researchers’ surprise, many came to discuss their “muscle dysphoria.” The body image of many was as distorted as a reflection in a fun-house mirror. It was not uncommon for 250-pound muscle men to confess that, big as they were, they felt too puny to go outside without two and three shirts on to make them appear even bigger. The entire life of some of these hulks is consumed by exercise, eating, and scoring very expensive and often illegal supplements. Since their attention is always riveted on the next dose or on the next day’s workout, their relationships and career prospects often dry up. A number of these men went into treatment for their distorted body images and self-destructive obsessions.

Since Americans are not exactly the fittest people on the face of the earth and since as a nation we are off the charts in obesity, it is not always easy to muster sympathy for the authors’ sense that American men are too caught up in exercise and diet. Still, this book presents an important glimpse into hidden recesses of the modern male mind.