Beyond Good Intentions

In my work as a psychotherapist, where many of my clients are LGBT+, I have often found myself reflecting on what it really means, in practice, to be an affirmative practitioner. Most therapists, I think, want to respond with care and competence when questions of sexuality, gender or identity arise in the room. Even so, it is not unusual to feel uncertain at times: about language, about timing, about what to ask, what not to assume, and how best to understand what is happening between us.

Carl Rogers’ writing reminds us that Unconditional Positive Regard matters deeply in therapeutic work, but also that it is not simply something the therapist feels or intends. It has to be experienced by the client as empathy, acceptance and genuine contact (Rogers, 1957). In that sense, it is not enough that I mean to be warm, respectful and safe. The client does not encounter my intentions directly. They encounter my words, my hesitations, my assumptions, and the quality of contact in the relationship. What feels thoughtful from one side may still land as awkward, over-careful or quietly presumptive from the other.

I have become more aware of this over time, especially in those moments when the therapist is trying hard to get it right. A client mentions an ex-partner, and the therapist moves too quickly into questions that reveal they have already made assumptions about the relationship, perhaps through the casual use of presumptive pronouns. Or a client begins to speak about discomfort in relation to their gender, and the therapist, anxious not to offend, becomes so careful and self-monitoring that the room begins to feel tense and oddly fragile. In attempting to protect against shame, the therapist may over-normalise and, in doing so, inadvertently bring shame into the space. None of these responses are malicious, and all may come from a place of care. Yet moments like these can shift the work away from the client’s unfolding meaning and towards the therapist’s effort to manage uncertainty.

This is where I think the gap between intention and practice becomes important. A therapist may think of themselves as open, inclusive and affirming, and may genuinely be all of those things. But that does not automatically mean the room feels safe enough for the client to bring more of themselves into it. Relational safety is not created by care alone. It is shaped in the finer details of contact: what gets assumed, what gets asked, what gets followed up, what is left alone, what seems to require explanation, and what is simply allowed to be there.

Drego’s concept of the Cultural Parent has been useful to me in thinking about this. It offers a way of understanding how wider social messages become internalised and carried into the room, often quietly and without much awareness (Drego, 1983). Therapists do not stand outside culture simply because we are reflective or well-intentioned. We also inherit norms about gender, sexuality, relationships, legitimacy, and what a coherent life is ‘supposed’ to look like. Even if we consciously reject narrow ideas, those broader messages may still show up in subtler ways: in what feels familiar, in the meanings we lean towards, or in how quickly we organise a client’s experience into a narrative that makes sense to us.

At the same time, this is not only a sociocultural question; it is also a relational one. Clarkson’s work on the therapeutic relationship is especially helpful here because it widens the frame beyond technique. Clients do not come into therapy as blank slates, of course. They arrive as full people, with past experiences, expectations and sensitivities that shape how they understand the therapist and the space between them. Therapists, too, bring their own assumptions, responses and histories into the room. The reparative relationship often feels especially important in my work, particularly for clients who have been misread, shamed, or implicitly or explicitly required to edit themselves in order to remain acceptable, lovable or safe. Clarkson’s person-to-person relationship may be especially relevant as well: clients often seem to know very quickly whether they are encountering a therapist who is genuinely present and with them, or someone leaning too heavily on a professional idea of what acceptance should look like (Clarkson, 1990; 2003).

In my experience, affirmative practice does not depend on perfect language or immaculate self-awareness. One of the difficulties for therapists is often the wish to get it right, and that wish can itself become a kind of interference. We may become overly formal, too eager to signal our good intentions, or too anxious about making a mistake. Certainly, we need to be informed; it is not the client’s job to educate us about, for example, what asexuality means. But it is for the client to share what their own experience means to them, provided the therapeutic relationship feels safe enough to support that exploration. Sometimes that anxiety narrows the room just as much as assumption does. The client may find themselves bringing not only their own material, but also managing the therapist’s carefulness.

However, effective psychotherapy is far from an exam in correctness. It matters because language carries assumptions, and because words shape what becomes possible in a relationship. They can make room, or they can close it down. They can invite the client’s own meanings, or they can suggest that the therapist has already decided what sort of story this is. In my experience, what many clients are looking for is not flawless terminology, but a therapist who can stay open, responsive and undefended enough to be corrected, surprised, or taken somewhere unfamiliar. Even when a therapist gets something wrong, there can be value in being able to own the assumption and learn in the moment. That kind of modelling can itself be deeply human and impactful.

What affirmation may ask of us, then, is perhaps more demanding than simple acceptance. It may ask for attention to what feels normal or coherent to us, and why. It may ask us to think more carefully about power, about the social norms that enter the room with both therapist and client, and about the difference between curiosity and intrusion. It may ask us to tolerate uncertainty for longer, especially when a client is still finding their own language for something. And it may ask us to understand safety not as something we declare, but as something built and rebuilt in the relationship.

This feels important not only when working with clients who explicitly identify as LGBT+, but whenever themes of identity, belonging, shame, desire, relationship or difference begin to surface. A display of fluency does not, in itself, mean that a client feels safe or connected. What matters more, in my experience, is the possibility of a relationship in which the client does not feel managed, corrected, over-read, or gently pulled back into something more recognisable. The challenge is not simply to mean well, but to help create the conditions in which another person has more room to understand themselves, particularly those aspects of self they may have struggled to name, accept, or bring safely into relationship with another.

These are some of the questions I have been thinking about in preparing for Unlearning Straight Lines, a one-day workshop at Connexus exploring LGBT+ affirmative practice. The title speaks to something I keep returning to in this work: how easily we can reach for tidy narratives, familiar assumptions, or culturally sanctioned lines of meaning, and how important it can be to loosen those in order to meet the person in front of us more fully.

References

Clarkson, P. (1990). A multiplicity of psychotherapeutic relationships. British Journal of Psychotherapy.
Clarkson, P. (2003). The Therapeutic Relationship (2nd ed.). London: Whurr/Wiley.
Drego, P. (1983). The cultural parent. Transactional Analysis Journal, 13(4), 224–227.
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology, 21(2), 95–103.