Since 2007, I have worked across more than 16,000 client sessions, and one thing has become impossible for me to ignore: what brings someone into therapy is rarely the whole story.

Across all those years, only around ten men have decided very quickly that they did not want to continue working with me. Of those, only one or two have ever become so confronted by what emerged in the session that they left abruptly.

Even fewer women have reacted that strongly.

I don’t find this interesting because I expect people to like me. Therapy is not about being liked. What interests me is what happens when something touches a person so deeply that stepping away feels easier than staying with what has been uncovered.

My work is direct, but direct does not mean unsafe. 

I listen carefully to what someone tells me, but I am equally interested in what sits underneath the story. The contradictions. The patterns. The loyalties. What we defend. What we blame. What we avoid. The things we have spent years believing because seeing them differently might require us to see ourselves differently too.

Most people can tolerate that.

They may become emotional. They may feel uncomfortable. They may need time to digest something they have never considered before.

But they remain curious.

And curiosity matters enormously in this work.

On the very rare occasion someone becomes intensely angry or leaves abruptly, I am interested in the reaction itself.

Sometimes being challenged touches shame.

Sometimes it threatens an identity a person has spent years building.

Sometimes someone has become so certain that the problem exists entirely outside of them that even considering their own part in the dynamic feels unbearable.

And sometimes being deeply seen is more confronting than remaining deeply unhappy.

In my own work, I have noticed that the strongest reactions of this kind have more often come from men.

That does not mean men are less capable of deep emotional work. I have worked with thousands of men who are extraordinarily willing to look at themselves.

But many men have been taught to protect themselves through competence, control, certainty and self reliance. When we move underneath those protections and begin talking about vulnerability, grief, fear, shame, dependency, or the relationship they had with their mother or father, something can shift.

For some men, emotional exposure can feel less like insight and more like losing control.

Women can defend too. Women intellectualise, blame, avoid, resist and protect themselves in exactly the same ways.

Yet interestingly, I have had even fewer women become so confronted that they simply refuse to continue.

The few who have stand out.

Some have returned years later, ready to revisit something they simply could not face at the time.

And that has taught me something important.

Change requires readiness.

You cannot force insight.

You cannot force vulnerability.

And you cannot force someone to face a truth before they have the capacity or willingness to meet it.

Sometimes a person needs to step away. Sometimes they need to live more life. Sometimes the same pattern has to hurt a little longer before they are willing to look at it differently.

Perhaps women have historically been given more permission to examine relationships, emotions and vulnerability. Perhaps many women arrive in therapy already accustomed to questioning themselves, sometimes far too much.

Many men have been taught something different.

Don’t show weakness.

Sort it out yourself.

Stay in control.

Don’t admit you are frightened.

Don’t admit you don’t know.

Then they enter a therapeutic space where those protections may no longer help them.

Because eventually deep therapeutic work asks something much harder:

Can you tolerate seeing something about yourself that you would rather not see?

That is not a male question or a female question.

It is a human one.

And for me, this is where therapy can become something more than simply solving a problem.

At its deepest, it can become a journey back to the self.

A spiritual journey in the sense of stripping away the roles, defences, loyalties and stories we have carried for years and asking:

Who am I underneath all of this?

That is often where real change begins.

After more than 16,000 client sessions, I am still fascinated by the difference between the person who hears something confronting and says, I need to think about that, and the person who needs to reject what they have heard before they can even consider it.

The people who change are not the people who are never confronted.

They are the people who become willing, when they are ready, to stay curious about why something confronted them in the first place.

And perhaps that is what this work is ultimately about: not becoming someone new, but finding our way back to who we were before we learned who we thought we had to be.