Three Ways the Therapist’s Self Shapes Therapy

In a recent session, after a client described feeling devalued at work, they looked at me and said, “Your expression—I feel so validated.”

I was surprised. I hadn’t been aware of my face revealing any emotion. But as we’d talked about it, it became clear that they’d registered the anger and indignation I’d been feeling on their behalf.

This incident wasn’t the first time a client had caught a glimpse of my internal reaction without my being aware of what I was revealing. A part of me felt a bit sheepish for being so easy to read. A colleague I know uses Botox so that she can maintain a calm expression when working with inmates who often share frightening stories of violence with her. But is a neutral affect even something I should try to cultivate? In other words, is my way of being as much a part of the treatment as my interventions? Carl Rogers would say yes, asserting that congruence, empathy, and unconditional positive regard—qualities of the therapist’s person—are crucial catalysts of change.

In another session where I was obviously moved, a different client said, “Your responsiveness makes me able to trust enough to share things I haven’t shared with other counselors.” This reaffirmed for me that what we experience internally as therapists doesn’t always need to remain private: it enters the relational field.

While a therapist’s unregulated expression can disrupt the work, suppressing our responses can produce something equally problematic—a relational environment that feels thin or unreal. From an attachment perspective, this matters. Clients orient to safety and meaning through accurate mirroring. When my reactions are attuned—neither excessive nor absent—they confirm that you’re having an impact on me. You exist here. What you feel registers. In philosopher Martin Buber’s terms, the client becomes real in the presence of a responsive other. The therapist’s person is not incidental to treatment. It’s one of its primary instruments.

This question points to something broader and much harder to pinpoint and define than any choice or technique: how much of what happens in our work with clients is shaped not by what we do as therapists, but by who we are? In my practice, I’ve noticed how identity and experience enter treatment through several distinct channels. My training, history, and identity are always shaping what I pick up on and what becomes clinically meaningful as a result.

Different therapists sitting in the same room with the same client won’t end up experiencing the same session. They’ll notice different narrative contradictions, track attachment patterns differently, and register distinct bodily movement or symbolic cues that lead them to intervene in their own way. The person of the therapist shapes perception as well as interpretation.

How Life Experiences and Training Shape What We Notice

Before becoming a therapist, I was a professional ballet dancer. Subsequently, I became a Pilates and yoga teacher who specialized in analyzing movement and adapting it for injured and disabled clients. These previous roles and training experiences left me with a habit of watching people’s feet and gait. In my office, clients remove their shoes, which facilitates grounding but also provides information on how they connect with the ground.

During my counseling internship, Donna, a 36-year-old woman came to therapy with chronic pain in her hips and lower back. She’d suffered sexual abuse and had been in foster care with several placements in childhood before her adoption. Donna described feeling as if she always had to “tiptoe around”—in foster families and with her adoptive mother who’d “saved” her life, but who could be emotionally volatile.

As she walked across the room, I noticed two things immediately. Her feet were locked in high arches that never pronated when she bore weight, and her pelvis barely moved when she walked. The gait pattern suggested minimal floor contact, more like walking on a precarious surface: rigid, cautious, controlled.

My background made these details hard to miss. When I brought this to her attention, we connected it with her metaphor of walking on eggshells and tiptoeing as a child to be inconspicuous. She admitted she also suffered from plantar fasciitis. I explained how optimal foot mechanics (pronation when loading, supination pushing off) have repercussions in pelvic mobility, providing natural movement in three dimensions throughout the entire body.

The idea that hips are supposed to move surprised her. “Really?” she exclaimed. “I thought you shouldn’t move your hips when you walk,” alluding to pelvic movement being naughtily suggestive.

I guided her in performing a few simple exercises to mobilize the feet and allow her hips to respond more freely. Nothing elaborate—just basic work to restore pronation/supination rhythm and pelvic motion. I was able to incorporate these interventions into our conversation about how fear and tension manifest in the body.

By the next session her pain had largely disappeared. She began experimenting with a looser, more playful way of moving that visibly shifted both her mood and affect. As therapy progressed, she was also able to explore the complicated emotional reality of her adoptive mother: rescuer and tormentor at the same time. While foot exercises alone may not resolve trauma, they can significantly change a client’s relationship to their body and to gravity, which may then facilitate experiences of freedom, empowerment, and self-trust.

In the training model and book called The Person of the Therapist, family therapists Harry J. Aponte and Karni Kissil delineate methods for developing and training clinicians’ therapeutic use of the self through targeted self-exploratory questions that heighten awareness of individual experience as both a resource and potential risk.

In this case, my movement training shaped what entered awareness when I first met Donna and informed what became clinically actionable. Many therapists would’ve heard the phrase “tiptoeing around my mother” as a metaphor and worked with it symbolically or relationally. My training allowed me to notice a literal motor pattern that matched the metaphor and expressed the feeling somatically. Because perception is trained, different therapists inhabit different clinical worlds even in the same session.

What Becomes Meaningful

Therapists also differ in what they treat as symbolically meaningful. Although I don’t work with children, stuffed animals are prominent in my office. They sit on shelves, and I keep a basket of them next to a chair my clients often use. Adults will reach for them during sessions, and I pay close attention to which objects clients gravitate toward.

Courtney came to therapy grieving the loss of a professional athletic career that had not only provided them with an identity but served as a primary mechanism of emotional regulation. When over-efforting finally led to a serious injury, both their career and the regulatory system they’d developed collapsed.

In one session they picked up a stuffed otter from the basket and held it while we talked. Rather than ignoring the gesture, I asked about it. They shared feeling vulnerable as a child and compensating by pushing themselves athletically to gain both the love and recognition they desperately needed. At the end of that session, I suggested they take the otter home as a reminder to care for what the poet Mary Oliver calls the “soft animal of the body,” from her poem Wild Geese. Courtney had read the poem out loud in a previous session, and it had meant a lot to them.

The otter became a transitional object which served as a reminder of Courtney’s tender, “soft” self when the impulse to overtrain or push through pain arose. Over time it came to represent two important aspects of their life: the vulnerable inner child who’d suffered emotional neglect, leading them to perform to prove their worth, and a reminder to relate to their body with care and love.

My love of stuffed animals comes from growing up in a household where objects carried historical, cultural, and relational meaning. In therapy, they can become tangible images of the psyche—companions, protectors, talismans—that clients can hold in their hands. These objects sometimes provide security and grounding, giving form to feelings that are otherwise difficult to name.

Containing and Disclosing Identity

Sometimes the therapist’s person enters the work through identity rather than perception. My 19-year-old client Bruce expressed extremist political views, including open admiration for Nazi ideology.

What he didn’t know was that I’m Jewish, and that on my father’s side, a member of my family was prominent in the Italian military which, at that time, was under a Fascist regime. These two dichotomous ancestral tensions are present in my family history, my DNA, and my awareness.

During our first year of treatment, I simply contained my reactions. At times, I felt myself harden internally when I was triggered by his stance or a particular comment. I used breath, self-compassion, and mental reminders that his stance was the result of suffering. My internal adjustments happened quickly and hopefully, invisibly. These were auto-interventions that help me maintain spaciousness when I assessed that disclosing my reactions to him wasn’t clinically appropriate.

I appreciated Bruce’s intelligence, vulnerability, and dedication to showing up. He had extensive trauma that included being the victim of both physical violence and emotional neglect, and once even had to call the police when his father tried to strangle his mother. However, I had to exercise significant emotional labor when working with him: holding anger, grief, and disbelief while maintaining warmth and curiosity. The goal was not neutrality in the classical analytic sense but the preservation of a relationship in which connection remained possible.

At the same time, I was mindful that my internal world was part of the diagnostic instrument I was using with him. Psychiatrist Paula Heimann and psychologists Nancy McWilliams and Jessica Benjamin reframed countertransference from something that contaminated sessions to something that offered clinical data about clients’ unconscious communication, highlighting that the therapist’s internal experience can become information about the relational system.

Toward the end of our work together, when Bruce and I were discussing his tendency toward black-and-white thinking, I decided to disclose the dichotomy between my maternal Jewish ancestry and paternal military history. The moment functioned less as confrontation than as reality testing. The person sitting across from him—someone he’d come to trust—was also a member of the groups he spoke about abstractly.

When therapy concluded two years later because he was leaving town, he told me something striking. My appearance, he said—bald, tattooed, “weird”—had initially led him to assume I’d be “one of those people who yell at me in protests and call me a fascist.” Instead, he felt my acceptance and lack of judgement. He added that the experience had changed him somewhat, even though our political views would never align.

My identity had been present in the room from the beginning. Perhaps because I already held the tension between these two familial narratives, I was able to sit with him more easily. The disclosure simply made explicit what had already shaped the relational field.

Psychotherapy training often emphasizes technique: models, interventions, protocols, and measures. These matter. But they operate through a more fundamental medium—the therapist, the instrument in the room. Of course, there are always pitfalls when it comes to leveraging the self of the therapist in our work. Biographical resonance can lead to over-identification. Symbolic sensitivity can tempt us to see meaning where none exists. Identity conflicts can provoke reactions we struggle to contain. The same perceptual habits that make certain interventions possible can also create blind spots. For that reason, the concept of the person of the therapist isn’t simply an invitation to authenticity. It’s an invitation to study ourselves as instruments.

Our lived experience, histories, and emotions train our attention. Our identities shape the emotional field, influencing the atmosphere in which clients think and feel. The person of the therapist doesn’t merely color the work. It determines what becomes visible. And once something becomes visible, therapy can begin.