When Feeling Safe Changes How We Experience Distress: Reflections on the Therapeutic Relationship

Can the very thing that makes therapy effective sometimes influence how we access difficult emotions?

One of the greatest privileges of being a therapist is creating a space where people feel genuinely safe, comfortable and understood.

For some clients, therapy becomes somewhere they look forward to being. A place where they can speak openly, explore difficult experiences and feel supported without judgement.

I've often reflected on just how powerful the therapeutic relationship can be. Not simply because of the techniques we use, but because of what happens when someone feels safe in another person's presence.

This has led me to consider an interesting concept sometimes described as the 'therapist as placebo'.

The therapist as placebo: What does it mean?

Traditionally, we associate the placebo effect with improvements arising partly from expectations, beliefs and the context in which treatment is delivered. Within psychotherapy, however, the concept becomes more complex. The relationship between therapist and client isn't simply a background feature of treatment. Trust, empathy, reassurance, expectation and feeling understood can all contribute meaningfully to therapeutic outcomes. Perhaps the therapist's presence can, in itself, influence how someone experiences their difficulties. And that raises an interesting question.

If someone feels particularly safe and settled in therapy, might that temporarily change how they experience the very distress they've come to address?

When a difficult memory no longer feels difficult

This is something I've become increasingly curious about through my work as a therapist.

During the assessment and preparation stages, clients may identify a difficult memory, recognise the emotional impact it continues to have and describe the physical sensations associated with it. They may even identify a significant level of distress when recalling that experience. Yet, when we begin working with the memory, something interesting can happen. The client remembers what happened. They recognise why it was distressing. They understand the impact it has had on their life. But, in that moment, they struggle to connect with the emotion or physical sensations previously identified. Sometimes, they describe feeling entirely comfortable and settled. I've wondered whether the sense of safety within the therapeutic relationship might contribute to this experience. Of course, there are several possible explanations. Reduced emotional intensity might reflect genuine therapeutic progress, a temporary change in emotional state, difficulty accessing the memory, or other psychological processes.

The important distinction is that remembering something distressing isn't necessarily the same as experiencing distress in the present moment.

Why we shouldn't force an emotional response

Occasionally, clients have suggested that they could try harder to feel the emotion or deliberately bring the distress to the surface. But I don't believe meaningful therapeutic work should involve manufacturing an emotional response. If an emotion isn't naturally accessible, trying to force it may shift the focus away from the client's genuine experience.

Equally, the absence of strong emotion doesn't necessarily mean that nothing useful is happening. Within therapy, processing can involve changes in thoughts, perspectives, memories and physical sensations. Not every meaningful change is accompanied by an intense emotional reaction. For me, this reinforces the importance of remaining curious rather than assuming what a client should be feeling.

Safety and therapeutic change

Perhaps one of the most interesting aspects of therapy is that safety can serve several purposes. It can help someone feel confident enough to approach difficult experiences.

It can provide the reassurance needed to explore painful memories. And it may influence how those experiences are felt and understood in the present. But feeling safe in therapy and experiencing lasting change outside therapy are not necessarily the same thing.

The aim isn't simply for someone to feel better in the therapy room. It's to help them experience meaningful change in their everyday life.

That means understanding whether reduced distress reflects a lasting change in how a memory is experienced, or whether the response is different when the person returns to the situations and environments where difficulties arise.

A reflection on the role of the therapist

The more I reflect on my work, the more I recognise that therapy isn't simply about applying a technique. It's about understanding the person, their experiences, the relationship we develop and the many factors that influence how change happens. Sometimes the most valuable thing we can do is recognise that the process isn't unfolding exactly as expected and remain curious about why. I don't see the therapeutic relationship as a substitute for effective psychological treatment. I see it as an essential part of creating the conditions in which that treatment can be meaningful.

And perhaps that is where the real value lies.

Not in making someone feel a particular emotion, but in helping them understand their experiences, develop confidence in their own ability to cope, and create change that continues long after they leave the therapy room.

At flourish, I believe therapy should be collaborative, thoughtful and responsive to each individual.

Because meaningful change isn't about forcing a process.

It's about understanding what someone needs, meeting them where they are, and supporting them to move forward.