A Reflection on Therapy, From a Therapist

I recently had what most people would probably describe as a somewhat funny interaction with a friend.

I was standing alongside them while they were introducing me to someone new and explaining what I do for a living. The person showed genuine interest and asked, “So what does it actually mean to be a psychologist?” Before I could answer, my friend laughed and said, with no ill intent at all, “Basically, she talks and listens to people for an hour and gets paid for it.”

To be fair, I’ve heard variations of this more times than I can count- right up there with “Are you reading my mind right now?” or “Are you psychoanalysing us?” when meeting new people. But this time, something made me pause. I turned to my friend and asked, “Is that really what you think I do?”

And honestly? Their genuine understanding of what therapy involves was almost exactly that: listening and talking for an hour.

Sadly, this highlights a very common misunderstanding, that psychotherapy is about giving advice, lecturing, or simply “having a chat.” So I want to gently pull back the curtain on what is actually happening in that hour, from the therapist’s side.

In a therapy session, a therapist is not "just listening". And therapy isn’t “just talking.” It is deeply intentional, reflective, and emotionally demanding work, and it doesn’t begin and end neatly when the hour does.

During a session, we are actively finding and maintaining a particular internal state, one grounded in non-judgement, empathy, curiosity, compassion, calmness, creativity, confidence, and courage. All at once.

We are listening while holding multiple layers of information simultaneously: what is being said now, what has been said in previous sessions, and what is happening emotionally in the room in this very moment. We attune closely to subtle shifts; tone, posture, pauses, changes in affect, often before either of us has words for them. We pause intentionally before responding rather than reacting, and we hold space for uncertainty, doubt, and not-knowing.

At the same time, we are monitoring our own internal responses, maintaining clear emotional and cognitive boundaries, and understanding your experience through the lens of a specific therapeutic model. We hold structure while staying flexible enough to meet whatever unexpectedly emerges.

So what are we actually doing in those quiet moments, in therapy, and outside of it? Because therapy is not just the hour we sit with clients. Our work, unlike many others, does not end when the clock strikes the hour.

What are we doing before your session, during it, and after it?

We reflect.

We take notes.

We wonder.

We question.

We think about you. We think about ourselves. We think about the space between us, the relationship, what you are bringing now compared to what you brought before, and what you might bring next.

In truth, we think about you far more than you might realise.

Sitting across from someone for an hour while they share something deeply painful, embarrassing, traumatic, or perhaps something they have never told another living soul, requires complete presence. For that entire hour, we are not just listening. We are reflecting and empathising, synthesising what you are saying, and what you are not saying, and trying to put words to experiences you may still be struggling to articulate yourself.

We track your story over time, connect themes across sessions, and help you make sense of it all. We draw on years of psychological training and different therapeutic modalities to consider how past experiences, relationships, attachment patterns, and emotional processes may be shaping this exact moment for you right now. We listen for deeper meaning, for core beliefs that may be quietly influencing how you experience the world, and we formulate this in a way that is intended to be helpful for you, as an individual.

This is where therapy differs fundamentally from talking to a friend. Friends often give advice, share opinions, or tell us what they think we should do. Therapists are trained not to do this. We don’t steer your life in a particular direction, impose our values, or let our own feelings drive your decisions. We don’t “play god.” Instead, we create space for you to understand yourself more deeply and make choices that are aligned with your own values and needs.

To put it simply: when you talk to a friend about a relationship, their feelings about your partner might shape what they say, and how safe you feel sharing more in the future. In therapy, we aim not to collapse the space in this way. Instead, we might reflect that you sound uncertain or conflicted, and gently explore why this relationship feels difficult for you, perhaps linking it to patterns you’ve brought before but not yet seen.

And this brings me to one of the most difficult aspects of being a psychologist to explain: countertransference.

Countertransference is the ongoing process of noticing and reflecting on what we feel in response to what you share. We are constantly asking ourselves whether an emotion belongs to us personally, whether it is a natural response to what we are hearing, or whether it may be something being projected into the therapeutic space. We hold and examine these responses carefully, because they matter, and because they can offer valuable information when understood properly.

We are doing all of this while simultaneously doing everything else described above, every minute of every hour we spend with you.

And when the session ends, we don’t simply move on. We sit with our thoughts, feelings, and responses. We reflect on the work. We consider how best to continue holding the space in a way that is ethical, attuned, and genuinely helpful.

So no, therapy is not just talking and listening for an hour.

It is presence. It is thinking. It is emotional labour. And it is care, in its most intentional form.

Therapy is structured, ethical work grounded in training, supervision, and ongoing reflection, even when it appears quiet from the outside.

So, if this feels tiring just to read, it offers a small glimpse into what therapy actually asks of the space.

And if you’d like to “just chat” sometime, you know where to find me.