What Your Therapist Really Thinks About You
TL;DR: Behind the room: Psychodynamic Psychotherapist Rick Cox reveals the truth behind the room: we don't judge you. Learn how therapists focus on your courage, tackle the inner critic, and use depth work to facilitate profound emotional transformation.
Behind the room: Part 1 of the 3-part series
Explore more in: The Therapist’s Silence: What it really means and What Therapist’s Feel, But Rarely Say
A moment of quiet reflection, the pause between self-protection and self-understanding.
The Voice That Lies
If you have ever stopped talking in therapy because you felt your life was too messy, your problems too trivial, or your feelings too much, you are not alone. That moment is dictated by the punishing internal voice, the inner critic, which convinces you that the therapist is secretly judging you or is tired of listening.
I want to dispel that myth entirely.
The truth, told behind the room, is simpler and kinder than you fear: Therapists think about how to help you become more fully yourself. We do not see weakness; we see a map of old struggles, and our energy is entirely focused on helping you heal beyond that history.
The Therapist’s Perspective: Insight, Not Judgement
What does a psychodynamic psychotherapist actually think about? We are trained to think relationally and structurally. This means our focus is never on who you are, but on what you’re doing in the moment to protect yourself from old pain.
When you feel ashamed, we see shame as a symptom of the past, not a character flaw. We observe the powerful defences that spring up to manage the anxiety of feeling vulnerable.
The questions running through my mind are fundamentally technical and caring:
• What feeling is rising right now that you are working so hard to avoid? (This relates to Emotional Avoidance.)
• What courageous part of you showed up today, even though the internal critic told you to cancel?
• What past relationship pattern (re-enactment) is playing out right here, right now?
We are not judging the content of your life; we are deeply engaged in trying to understand the unconscious emotional patterns that hold you captive.
What We Really See: Your Fierce Loyalty to Yourself
If we think anything about you, it is how hard you are working, often against yourself.
The most profound feeling we hold for our clients is often respect for the sheer act of defiance that therapy represents. You are actively turning toward the fears that keep you stuck. This is the essence of courage.
When a client arrives, having faced down the crippling anxiety just to sit in the chair, we see strength. When a client begins to name a feeling that has been avoided for years, we recognise the profound internal movement of emotional integration.
You Are Already Enough
As a psychodynamic practitioner integrating ISTDP principles, I think about the potential you are trying to reach. The process is not about "fixing" you; it’s about creating a relationship where you can reclaim your voice, figure out your identity, and build healthier relationships.
You Are Already Enough
You worry that we think you are incapable of change. We don't. We believe that lasting change is possible because we witness the moments when you choose to stay present and confront your feelings.
The client's fear is that they are being weighed and found wanting. The reality is that we are simply observing the symptoms, the anxiety, the self-sabotage, the repetition, and helping you realise that the pain you feel isn’t who you are; it’s what you’ve carried.
What your therapist truly thinks about you is this: You are inherently capable of emotional freedom. Our job is just to hold the space securely and patiently until you discover that truth for yourself.
Continue reading the Behind the Room series: What Therapists Feel, But Rarely Say and The Therapist’s Silence: What it really means
If this reflection resonated, you might explore:
When Growth Feels Like Collapse
Why Therapy? The Real Question Nobody Asks
From Pain to Possibility: What Nine Inch Nails: The Downward Spiral Teaches Us About Being Human
We don’t think about you from a distance. We think with you, holding what you’re not ready to hold alone.
Explore more in reflections
Do you want to feel listened to?
If this topic connects with your experience, discover how I help clients work through it…
FAQ: What Your Therapist Really Thinks About You
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No. A good therapist isn’t assessing your worth, they’re attuning to your experience. Judgement closes the space; curiosity opens it. Therapy works because your therapist can hold what feels unbearable without turning away.
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Often, yes. Therapists reflect, take notes, discuss themes in supervision, or simply wonder how you’re feeling. You occupy mental space not out of obligation, but care. It’s part of the work’s continuity; what happens between sessions matters.
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They will. That’s called countertransference, the therapist’s emotional response to you and your story. When handled well, it’s not a boundary violation but a compass. It helps them understand what you might be feeling without words.
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Therapists can feel warmth, frustration, admiration, even sadness toward clients. What defines therapy isn’t the absence of feeling, but how it’s used. Every emotion becomes material for understanding the relationship and, through it, your history.
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Yes, but ethically. The therapeutic bond is meant to be real, human, and bounded. Healthy attachment is the engine of change. You’re not meant to be forgotten; you’re meant to be internalised, to carry that steady, containing presence inside you long after therapy ends
