What Is Your Therapist Actually Thinking During Your Session

Spoiler: It's not what you think.

"Are You Judging Me Right Now?"

Here's what I hear a lot from clients, especially in early sessions:

"I know this sounds stupid..."
"Sorry, I'm rambling..."
"You probably think I'm being dramatic..."
"I'm sure you've heard worse..."

And every time, I want to stop them and say: That's not what I'm thinking. Not even close.

Most people come into therapy worried that I'm sitting here judging them, or passively listening and waiting for them to figure out the "right" answer that I already know, or just... waiting for the session to be over.

That's not what's happening in my head. Not even a little bit.

So let me pull back the curtain and tell you what's actually going on.

The "Aha" Moment

A few weeks ago, a client mentioned an old memory—something from childhood that just popped up. They hesitated, unsure if it was even relevant to what we'd been talking about.

"I don't know if this matters," they said. "It's probably random."

Meanwhile, in my head, I'm thinking: Ohhh my gosh! This might be the missing link that explains everything!

The pattern they'd been struggling with for years? The way they handle conflict? The belief that their needs don't matter?

This memory—this moment they almost didn't share—made it all make sense in a new way.

At that moment, sitting there looking calm and attentive, my brain was lighting up like a Christmas tree. Pattern recognized. Dots connected. This is going to be important.

That's what I'm thinking when you share something you think is "probably nothing."

What's Actually Happening in My Brain

Let me break down what's going on while you're talking:

Pattern Recognition
I'm constantly looking for patterns. The way you talk about yourself. The themes that keep showing up across sessions. The connections between what happened in your childhood and what's happening now.

Pulling in Past Information
I'm holding bits of information from your intake, from five sessions ago, from that thing you mentioned in passing last month. I'm weaving it together, trying to see the full picture.

Considering Systemic Issues
I’m considering what systemic issues might be at play that contribute to the way you are feeling, the issues you are facing, the barriers you might be confronting, and considering how to discuss them in a way that will feel validating and supportive. 

Tracking My Own Reactions
When something you say lands emotionally for me—when I feel sad, or angry on your behalf, or recognize something from my own life—I'm quickly sorting through: What part of this reaction is helpful to share? What part is about me and needs to stay with me?

The rule of thumb: I share when it's for you. I don't share when it's for me- that's what my own therapy is for.

Considering Interventions
What might help here? What resource could support this? Should I recommend that podcast I just listened to—or am I just excited about it and trying to share it with everyone even if it's not relevant?

Right now I'm on a "We Can Do Hard Things" kick, and I have to actively stop myself from recommending it to every single person who walks through my door. Though honestly, if you're reading this, it's probably worth a listen.

Noticing What You Don't Notice
I'm tracking your body language, the shift in your voice when you talk about certain people, the specific words you use to describe yourself.

When I Get Distracted (Because I'm Human)

Full disclosure: Sometimes my brain wanders. Not often, and not for long, but it does happen.

Maybe I had a third cup of coffee when I shouldn't have and now I'm trying not to bounce my leg or fidget with my pen too much.

Maybe something you said triggered a thought about my own life and I need to quickly compartmentalize it so I can stay present with you.

Maybe I'm managing a physiological reaction—feeling sad, or angry on your behalf—and I'm turning my attention back to you, making a mental note to process my own feelings later.

Maybe I had an intense interaction that day that is still eating up brain space and I’m working harder than usual to push it out of my awareness until I can digest it later. 

Maybe you are filling up space with tangential stories to avoid talking about that one scary-vulnerable-important thing and I’m struggling to stay locked in because I know we are dancing around the big issue.

Here's what I've learned: When my attention drifts, it's data.

Either I need to refocus because I've got too much on my mind or in my body. Or I need to find a way to share my experience because I believe it will be helpful to you. Or you might be avoiding the topics we really need to address and my brain drifting is a sign to refocus both of us. 

Sometimes it's just an ADHD moment. Sometimes it's clinically relevant.

I'm always asking myself: What is this telling me?

Therapeutic Silence Isn't Passive

When I'm quiet, I'm not just waiting for you to keep talking.

I might be:

  • Letting something land

  • Giving you space to feel what you're feeling

  • Deciding if now is the right time to name the pattern I'm seeing

  • Tracking how vulnerable you are in this moment and adjusting how gently I phrase what I'm about to say

Silence is active. It's not passive listening. It's holding space.

When I See the Pattern You Don't See Yet

This is the hardest part of my job.

You're telling me about your relationship, your job, your family—and I can see the pattern. I can see how you're repeating something, how you're stuck, how there's a way forward that you're not seeing yet.

And I want to just tell you.

But here's what I've learned: My timeline for your life is irrelevant.

If I point it out before you're ready, you'll dismiss it. Or agree with me intellectually but not actually get it. Or feel criticized and shut down.

So I wait. I plant seeds. I ask questions that might help you see it yourself.

And when I do name it? How gentle my language is depends entirely on how ready I perceive you to be.

Patience is necessary. Because it's about your timeline, not mine.

The Things I Can't Say (And Why)

There are things I think during session that I can't say out loud. Not because I'm judging you, but because of boundaries and ethics.

I can't tell you to leave your toxic partner or quit your terrible job. Even when I really want to.

I can't say, "That person sounds like a real asshole," until you say it first—or at least strongly allude to it so it's the most logical conclusion. And then I will definitely say it!

Why not?

Because I don't want to take away your sense of agency. I don't want to assume I know the path you're meant to walk or the timing of your decisions.

I try to stay humble and not to assume I know better than you about how you're meant to live your life. Because here's the truth: I've been wrong before.

I've sat in sessions internally thinking, "They should definitely leave this relationship," and then they stayed and worked through it and it ended up being the right choice.

I've thought someone should take a job, and they didn't, and their life went in a completely different (better) direction.

You know better about what's best for you than anyone else does—including me. My job is to help you get in touch with your truth. Not to put you in touch with mine.

What I Want You to Know

If you take one thing away from this, let it be this:

There are multitudes happening inside your therapist, even when we appear to be passively listening.

I'm not judging you. I'm not bored. I'm not waiting for you to figure out the answer I already know.

I'm tracking patterns. Making connections. Holding space. Feeling things with you. Deciding when and how to share what I'm noticing. Managing my own reactions so I can stay present with you.

I'm fully here. Fully engaged. Even when I look calm and still.

You're not too much. You're not wasting my time. You're not boring me.

You're doing the hardest work there is—being honest about who you are and what you're feeling. And I'm honored to be here with you while you do it.

What This Means for You

If you've been holding back in therapy—worried about what your therapist is thinking, afraid of saying the "wrong" thing, wondering if you're doing it "right"—please hear this:

Your therapist is on your side.

We're not here to judge you or fix you or tell you what to do. We're here to help you see yourself more clearly. To notice patterns you can't see on your own. To sit with you in the hard stuff.

And we're thinking about you—really thinking, deeply engaging—even when it looks like we're just quietly listening.

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