Four Thousand Hours: A Reflection on Depth, Distance, and the Digital Room
TL;DR: After four thousand hours of online psychodynamic work, I’ve learned that profound emotional work is possible when convenience meets courage. It depends on what both therapist and client can bear to feel, and what they can stay with long enough to transform. Depth work goes beyond ‘fixing’ surface-level symptoms. Here, we build the capacity to feel, experience your emotions and tolerate anxiety. So you can stop letting the history you carry dictate your present and derail your potential future. This is the path to emotional freedom…
Where the digital room becomes real: the quiet space where truth is met, one session at a time
The Measure of Time
Four thousand hours…
However many years ago, I used to think the 100 hours on voluntary placement were a milestone…
Four thousand hours…
That number carries weight, communicates experience, but not in the way I once imagined. My registering body requires 450 hours for their accrediting seal of approval. Okay, yes, 450 is more than 100, but still, what do we really know about helping to relieve human suffering with that amount of time spent? We could borrow the popular idea that 10,000 hours of deliberate practice leads to mastery.
But can we really measure this work in that way? Does four thousand hours mean I’m forty per cent of the way to mastery, or just forty per cent more aware of how much I don’t know?
Four thousand hours…
This number represents hours spent listening, challenging, and holding the emotional weight of courageous people ready to confront their deepest fears, crippling anxiety, repeating relational patterns and their punitive internal voice that insists they are not enough…. along with sometimes feeling like I’m drowning in my own counter-transference!
Maybe it’s become a badge of trust? It’s a record of encounters, thousands of moments when someone trusted me enough to stay present in the room when everything in them wanted to leave. Each time someone dares to feel instead of flee, they expand their own capacity, along with mine too. Therapy changes both people, or it isn’t therapy.
When I began, I wondered whether therapy through a screen could ever reach the same depth as in person.
I don’t wonder anymore. The answer is clear: online therapy works because it is, fundamentally, a portable, accessible container for the truth. Because what cures in therapy is truth. It allows you to face the chaos of your inner world without having to leave the relative safety of your own space. The screen softens the gaze, enough for truths to emerge that might feel unbearable in person. Distance can become permission.
The Capacity to Stay Present
Most people come to therapy feeling exhausted because their entire system is overwhelmed by unprocessed emotional history. They have spent years avoiding vulnerable feelings like grief, anger, or fear, which requires immense psychological energy.
The consequence? They develop rigid defences that keep them stuck. The self-sabotage, the avoidance, the over-intellectualising, these aren't flaws, but necessary survival strategies. They are how we handle overwhelming feelings.
In online therapy, this struggle unfolds clearly. We observe the moment anxiety rises, and the moment you pull back or divert the conversation, the moment the defence crystallises. The security of the therapeutic relationship, regardless of modality, allows us to be prompted to stay present with that anxiety. Because we care about your emotional state.
We work to stop you from letting anxiety drive you back into the defences that keep you stuck, helping you realise that the uncomfortable feeling is tolerable, and that the path to emotional freedom lies only in moving through it. The work is as much in the body as in the mind, a deep breath held too long, a jaw unclenching after years. That’s what release looks like.
Patterns That Endure
Four thousand hours teach you how predictable suffering can look, and yet how unique it always feels.
The same core sequence appears in every story:
Feeling → Anxiety → Defence.
The Therapy FAD, alive in real time.
Although this is nothing new in applied psychodynamic practice. It is an accessible framework and predictor to look out for in every session.
A client begins to touch something painful. Anxiety spikes. The defence appears, humour, logic, compliance, silence. The cycle is deeply human. My job is not to stop it, but to notice it with them, until the anxiety becomes tolerable, and the feeling can surface, be experienced, accepted and integrated.
Again and again, I’m reminded that progress doesn’t mean feeling better. It means feeling more fully and learning not to run from it, so you don’t have to let anxiety ru(i)n your life, or fall back into repeating cycles, or - insert self-defeating behaviour here -
Beyond Survival: The Truth About the Past
You arrive in therapy carrying the unfinished business of your life. You feel stuck because your history still lives on inside you, dictating your present.
The profound insight that emerges over hundreds and thousands of hours is this: the pain you feel isn’t who you are; it’s what you’ve carried.
My work, integrating psychodynamic depth and ISTDP principles, is centred on helping you separate yourself from that heavy load. We are observing the symptoms, the anxiety, the self-sabotage, the shame, and helping you turn toward the vulnerable feelings the inner critic works so hard to suppress.
This courageous confrontation is messy, uncomfortable, and anxiety-provoking. But every session spent leaning into that discomfort, rather than running from it, is a vote for yourself, a step toward a life that feels more your own, more connected, more grounded, and more yourself.
This is the power of the therapeutic relationship, even online. It is the safe space created for emotional integration, and it is where freedom begins.
The Therapist’s Growth
I’ve changed, too. These hours have increased my capacity for silence and extended my own tolerance for anxiety, uncomfortableness, and uncertainty. Every session has taught me something about what it means to stay present when instinct says retreat.
Supervision, remembering my own personal therapy, and reflection remain the unseen scaffolding that keeps this practice honest. Because without them, hours turn into repetition, and with them, hours turn into depth.
A Quiet Milestone
Four thousand hours…
It’s a marker on a path that continues to unfold. Each new client hour resets the counter. Each story asks the same question:
““Can we stay here long enough to find what’s true?””
The work remains the same, face what feels impossible, let the anxiety rise, wait, feel, something shifts.
Freedom doesn’t arrive all at once; it arrives in fragments, a moment of truth faced without escape.
That’s still the miracle…
A Note of Gratitude
To every client, past, present, and those I’ve yet to meet, thank you. You’ve trusted me with the most human parts of your story, often when trust felt impossible. Every hour we’ve shared has shaped the therapist I’ve become. You’ve taught me what courage looks like in real time and reminded me that the work is always mutual. For that, I’m deeply grateful.
The work goes on, one hour at a time, and every hour still asks for courage…
Testimonials
If this reflection resonated, you might explore:
The Therapy FAD? Rethinking our Feelings, Anxiety and Defences Across Modalities
The Power of Coming Back: Lewis Capaldi, Vulnerability, and the Quiet Strength of Resilience
The Hidden Map of Suffering: How the Three Core Fears Dictate Your Life: And How to Find Freedom…
Explore more in BetterHelp
Are you ready to find freedom?
If you’ve been hesitating to reach out for therapy, know that you don’t have to do it alone. Connection is possible…
FAQ: Depth, Distance and the Digital Room
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Yes, online therapy can be as emotionally deep as in-person when both therapist and client are willing to stay with what arises. Presence matters more than proximity.
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It’s your ability to experience strong emotions without being overwhelmed by them. Therapy builds that capacity, making space for change.
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Anxiety signals that something important is close to awareness. Together, we learn to stay with it rather than avoid it.
Acknowledgements
Glynis van der Hoek, Liza Chera, and Jon Frederickson, whose insight and guidance helped shape my practice. BetterHelp for welcoming me into their Brand Ambassador Programme.
About the Author
Rick is a UK-based Psychodynamic Psychotherapist and BetterHelp Brand Ambassador.
He focuses on emotional regulation, unconscious dynamics, and co-creating therapeutic relationships for lasting change.
From his bio:..
Psycho = Mind, Dynamic = Movement; together we do some movement of the mind.
Rick helps both clients and therapists understand how our feelings, anxiety, and defences shape our inner and outer lives.
