Therapy can be a deeply transformative process. For many who carry years of internalized shame and self-judgment—believing they are inherently “bad,” “wrong,” “weak,” “unlovable” or “not enough”—the therapeutic space offers a powerful corrective. Through consistent compassion and validation, clients often begin to view themselves with more kindness and self-understanding, sometimes for the first time in their lives.
However, this shift can sometimes create a new blind spot: the belief that the intensity of one’s emotional pain automatically indicates psychological pathology. In a therapeutic climate where discomfort is quickly framed as anxiety, trauma, or panic, there’s a risk of over-pathologizing the human condition. Not all suffering is a sign of mental illness. Sometimes, it’s simply life—complex, painful, and deeply human.
This dynamic becomes more pronounced when clients have been in therapy for a long time—especially if therapists hesitate to set boundaries or to challenge self-limiting narratives. When therapists avoid calling out avoidance, defensiveness, or distorted thinking—out of fear of rupturing the relationship or triggering the already distressed and hurt clients —they may inadvertently reinforce the client’s fragility. As Irvin Yalom (2002) emphasized, authenticity and confrontation are essential parts of therapeutic growth. Soothing alone is not enough.
Therapists must walk a careful line: validating emotional pain without pathologizing all distress. This requires a high degree of self-awareness and psychological maturity. As Carl Rogers (1961) famously said, “The curious paradox is that when I accept myself just as I am, then I can change.” That acceptance includes the ability to recognize that, like all human beings, we are fallible. True self-compassion doesn’t mean denying one’s flaws; it means being able to acknowledge them without shame.
Unfortunately, some clients begin to believe that because their pain is so overwhelming, it must be evidence of a disorder—and they may react with anger or withdrawal when therapists challenge that belief. But this over-identification with suffering, as Allen Frances (2013), editor of the DSM-IV, warned, can become a trap. It risks turning pain into pathology, and therapy into a space of endless affirmation rather than growth.
Viktor Frankl (1946) spoke powerfully to this in Man’s Search for Meaning: “When a person can’t find a deep sense of meaning, they distract themselves with pleasure.” In our context, the “pleasure” can even be the temporary relief that comes from labeling pain as a disorder—because it feels medical and solvable. But not all pain has a clinical solution, sometimes it must be witnessed, endured, and integrated—not treated.
The responsibility here lies equally with the therapist. If they haven’t done their own inner work, if they’re still seeking approval or avoiding discomfort, they may collude with the client’s avoidance. It takes months or years of self-reflection, supervision, and personal growth for therapists to develop the courage and clarity to gently, but firmly, name what’s really happening in the room.
Therapy, ultimately, is not about becoming perfect or symptom-free. It’s about building resilience and emotional autonomy. That includes being able to sit with pain that isn’t necessarily a “problem” to be fixed, taking accountability without collapsing into shame, and accepting the uncomfortable truth that we can be both deeply wounded and still be capable of harming others. When done well, therapy helps people move from fragility to resilience, from self-protection to self-responsibility—and from suffering to meaning.
References:
- Frankl, V. E. (1946). Man’s Search for Meaning. Beacon Press.
- Frances, A. (2013). Saving Normal: An Insider’s Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life. William Morrow.
- Neff, K. D., & Germer, C. K. (2009). A Pilot Study and Randomized Controlled Trial of the Mindful Self‐Compassion Program. Journal of Counseling Psychology, 56(1), 3–12.
- Rogers, C. R. (1961). On Becoming a Person: A Therapist’s View of Psychotherapy. Houghton Mifflin.
- Yalom, I. D. (2002). The Gift of Therapy: An Open Letter to a New Generation of Therapists and Their Patients. Harper Perennial.
- Bateman, A., & Fonagy, P. (2016). Mentalization-Based Treatment for Personality Disorders: A Practical Guide. Oxford University Press.
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