And How Does That Make You Feel?

1. Therapists are Attentive Listeners, Not Mind Readers

When we’re asking you—in the therapy room or in life—“And how does that make you feel?” it’s because we really want to know.

Attentiveness is Key. Therapists are trained to listen attentively, not to judge or psychoanalyze. Their goal is to understand and empathize with your experiences, creating a safe space for exploration. They are not lie detectors or mind readers, but compassionate guides.

Humanity of Therapists. Therapists are human beings with their own flaws and vulnerabilities. They don't have all the answers, and they constantly work on their own personal issues. This shared humanity helps to break down barriers and create a more genuine connection.

Building Trust. The therapeutic relationship is built on trust and a willingness to be a nonjudgmental guest in your world. Therapists aim to create an environment where you feel safe enough to open up and explore your thoughts and feelings without fear of shame or criticism.

2. Anxiety is an Evolved Threat Response, Now Often Misapplied

Anxiety is our body’s threat response; it is a powerful overriding mechanism that switches us into fight, flight, or freeze mode, just in case a “threat” is imminent.

Ancient Origins. Anxiety is an evolved threat-response mechanism that was crucial for our ancestors' survival. It helped them detect and avoid predators and social threats. However, in modern society, this mechanism is often triggered by conceptual and social anxieties.

Modern Threats. The lions and wolves of the past have been replaced by worries about achievement, social acceptance, and self-worth. The brain mechanism remains the same, but the threats are different, leading to misapplied anxiety.

Social Connection. The fear of rejection and ostracism, which posed a real threat to our ancestors, still drives much of our anxiety today. This can manifest as people-pleasing behaviors and difficulty saying no, stemming from a deep-seated need for social connection and safety.

3. Therapy Requires a Good Modality and Relationship Match

Training in any modality requires you to give your all to this way of practice, but in doing so it can create a whole world of cognitive dissonance when trying to view the world a different way, especially through the lens of another modality.

Modality Matters. There are many different therapy modalities, each with its own theoretical framework and approach. Finding a therapist trained in a modality that resonates with you is crucial for effective treatment.

Therapeutic Relationship. The connection between you and your therapist is just as important as the modality. A strong therapeutic relationship built on trust and understanding can significantly enhance the effectiveness of therapy.

Integrative Approach. Some therapists are trained in multiple modalities and can tailor their approach to your specific needs. This integrative approach can offer a more flexible and personalized treatment experience.

4. Panic Attacks are Terrifying but Understandable Phobias

A panic attack is when we suddenly feel an overwhelming sense that something awful is about to happen.

Overwhelming Fear. Panic attacks are characterized by a sudden surge of intense fear and physical symptoms, such as a pounding heart, shortness of breath, and dizziness. These attacks can be terrifying, especially for those who don't understand what's happening.

Physical Symptoms. Panic attacks are often accompanied by a range of physical symptoms, including derealization (feeling detached from reality), chest tightness, sweating, and digestive issues. These symptoms can intensify the fear and create a vicious cycle.

Fear of Fear. Panic disorder often develops when people begin to fear having panic attacks themselves. This fear can lead to avoidance behaviors and a constant state of anxiety, creating a "panic cycle" that can be difficult to break.

5. Intrusive Thoughts are Common and Treatable with ERP

They are intrusive because it sounds like you clearly don’t want to experience them.

Unwanted Thoughts. Intrusive thoughts are unwelcome, involuntary, and distressing thoughts, images, or urges that pop into our minds. These thoughts are often shocking, repulsive, or bizarre, and can cause significant anxiety.

OCD Connection. Intrusive thoughts are a hallmark of obsessive-compulsive disorder (OCD). People with OCD often experience these thoughts and engage in compulsive behaviors to neutralize the anxiety they cause.

Exposure-Response Prevention (ERP). ERP is a therapy technique that involves exposing yourself to the triggers of your intrusive thoughts without engaging in compulsive behaviors. This helps to break the cycle of anxiety and reduce the power of the thoughts.

6. Unhelpful Introjections Can Distort Self-Perception

Derived from the work of the great Carl Rogers, an introjection is an absorbed belief system that we can infer from any life experience.

Absorbed Beliefs. Introjections are beliefs and values that we internalize from our environment, often without conscious awareness. These beliefs can shape our self-perception and influence our behavior.

Childhood Impact. Introjections often occur during childhood, when we are more susceptible to external influences. These early introjections can have a lasting impact on our self-esteem and relationships.

Challenging Beliefs. Therapy can help you identify and challenge unhelpful introjections, replacing them with more accurate and empowering beliefs. This process can lead to greater self-acceptance and a more authentic sense of self.

7. Empathy Requires Stepping Outside Your Own Frame of Reference

This is the magical, transparent floating picture frame through which we gaze at the world.

Personal Lens. Everyone has a unique frame of reference through which they interpret the world. This frame is shaped by their experiences, beliefs, and values.

Empathy is Key. Empathy involves stepping outside your own frame of reference and trying to understand the world from someone else's perspective. This requires active listening, compassion, and a willingness to challenge your own assumptions.

Building Connections. Strong connections are formed through empathy and a shared understanding of each other's experiences. By stepping into another's shoes, we can foster deeper relationships and create a sense of belonging.

8. Vulnerability is Bravery, Not Weakness

I believe that sharing vulnerability is a form of bravery. One that doesn’t often get the plaudits, unfortunately.

Challenging Norms. Society often equates vulnerability with weakness, especially for men. However, sharing your true self with others requires courage and authenticity.

Building Trust. Vulnerability fosters trust and connection in relationships. When you allow yourself to be seen, flaws and all, you create space for others to do the same.

Authentic Living. Embracing vulnerability allows you to live a more authentic and fulfilling life. It frees you from the pressure of perfection and allows you to connect with others on a deeper level.

9. Self-Care is Personal, Not a Performance

Self-care is whatever you deem to be nurturing and wholesome for you.

Beyond Clichés. Self-care is often portrayed as a set of trendy activities, such as yoga, meditation, and green smoothies. However, true self-care is about finding what truly nourishes your mind, body, and soul.

Individual Needs. What works for one person may not work for another. It's important to experiment and discover what activities bring you joy, relaxation, and a sense of well-being.

Guilt-Free Zone. Self-care is not selfish or indulgent. It's a necessary practice for maintaining your mental and physical health. Give yourself permission to prioritize your needs without guilt or shame.

10. Emotional Conservatism Can Hinder Healing

The aim, for me, is not to encourage everyone to be a wailing neurotic, constantly at the mercy of their feelings (although you can be in my therapy room; it’s more than welcome), but to see expressing vulnerability as a positive shift for our own well-being, not a fundamental change to who you are.

Spectrum of Expression. People fall on a spectrum of emotional expression, from those who freely share their feelings to those who are more reserved. Emotional conservatism, or suppressing emotions, can hinder healing.

Fear of Vulnerability. Emotional conservatism is often rooted in a fear of feeling negative emotions or a belief that expressing vulnerability is a sign of weakness. This can lead to avoidance of difficult conversations and a reluctance to seek help.

Finding Balance. The goal is not to become overly emotional, but to find a healthy balance between expressing and processing your feelings. This can involve learning to identify and name your emotions, practicing self-compassion, and seeking support from trusted sources.

11. The Therapeutic Relationship Can Be a Powerful Force for Change

You made me feel safe. You made me feel heard . . . and seen . . . and made me feel like I exist without the mask of my public persona.

Unique Connection. The therapeutic relationship is a unique and powerful bond built on trust, empathy, and nonjudgment. This relationship can provide a safe space for exploration, healing, and personal growth.

Beyond Techniques. While therapy techniques are important, the quality of the therapeutic relationship is often the most significant factor in successful outcomes. A strong connection can help you feel understood, validated, and empowered to make positive changes.

Lasting Impact. Even when therapy comes to an end, the lessons learned and the connection forged can have a lasting impact on your life. The therapeutic relationship can serve as a model for healthy and supportive relationships in the future.

Last updated: April 23, 2025