Catching Flak: When Pushback Becomes a Wall

When I speak directly about problems in our field, as I did in a recent LinkedIn exchange, the reactions are telling. Many colleagues agree, admitting what they already see: therapy has slid into endless nodding, soothing, and emotional co-signing. Clients leave comforted for an hour but unchanged in their lives. Others admit they dislike this trend but feel pressured to conform to “hold space” rather than challenge. This isn’t new. Clients often come to me after cycling through multiple therapists, telling me the same story: “We just talked. I left feeling worse. I wasn’t challenged.” These aren’t isolated frustrations; they reveal a pattern, its a system more invested in soothing egos than building resilience.

And then there are the barbs. Not dialogue, not counterpoint, but mocking emojis, dismissive quips, or quick accusations that my approach is “harsh.” Those who respond this way don’t see it as avoidance. They see it as their truth, their reality. But what it reveals is an unwillingness to step outside the self,  to examine bias, to risk the discomfort of reflection, to ask whether their methods are truly working.

Which I would challenge is exactly what counseling and therapy were created to be: a discipline grounded in reflection, in curiosity, in the humility to question assumptions for the sake of helping another human being grow. When we shut down that process, when we confuse defensiveness for truth, we abandon the very purpose of this profession.

It creates an us vs. them dynamic: “I am compassionate, you are cold.” And when that line is drawn, meaningful dialogue ends. This division not only stalls conversation between colleagues but also confuses clients. It suggests that tough questions equal a lack of care, when in reality, the opposite is true. Clients deserve to know that being challenged is a form of deep respect; it communicates that their therapist believes in their capacity to grow. To claim compassion and accountability cannot coexist isn’t just false, it’s defensiveness disguised as reality. True therapy demands both: the presence of care and the courage to confront. Without that balance, we end up protecting the therapist’s comfort rather than empowering the client’s growth.

By contrast, many others on that same post did engage. Even when we disagreed, the conversation was thoughtful, respectful, and challenging. I later thanked them for that, because this is what our field desperately needs: dialogue that sharpens us, not divides us.

The Integrated Approach: More Than Feelings

I call myself an Integrated CBT Clinician. At its core, my work is grounded in Cognitive Behavioral Therapy; evidence-based, measurable, and effective. But integration means I go further.

• I address not just thoughts and feelings but the body’s safety responses, because trauma is not just psychological, it’s physiological.

• I draw from neuroscience to “wake up” interoceptive awareness and rebuild the brain’s ability to regulate.

• I use data, over 15 assessments, including the DES-II and PCL-5, to track progress, because clients deserve proof, not platitudes. I also hold myself accountable by requiring that my treatment demonstrate effectiveness.

This integration is often misunderstood. Critics mistake it for coldness, as though caring about measurement cancels out empathy. But the opposite is true. The willingness to measure, to hold therapy accountable, is compassion. Because compassion without accountability keeps clients trapped.

Why I Challenge Clients and Colleagues

My clients often say, “I’ve never had therapy like this before.” That’s because I ask the tough questions. I challenge destructive habit loops. I name apathy when it shows up. And if a client isn’t ready or willing to do the work, I am willing to end the relationship.

Ending is not a lack of compassion. In fact, it is compassion with boundaries. It communicates: “I will not enable your pain by pretending that talking in circles is progress.”

For example, I once worked with a client who faithfully showed up each week but refused to take a hard look at how alcohol had disrupted their life. In treatment planning, we agreed that intensive outpatient (IOP) treatment was the next step. Week after week, they chose not to follow through with assignments, practices of body scans, reframing, journaling, insight building, and more. The complaints stayed the same. The relief never came. When I asked what they had done in alignment with their treatment plan, the answer was always, “nothing.” At that point, the most compassionate challenge I could offer was this: “I know this is your Achilles heel, and you’re not ready to face it. But by taking your money each week and discussing the same thing without movement, I’m actually reinforcing the problem. I don’t want that for you. Let’s revisit this when you’re ready.”

Their immediate response was sharp: “I’ve never been fired by a therapist.” Yes, it was harsh. They were hurt, and that’s what they felt in the moment. I didn’t push back. I held that space and let them respond in anger. But what mattered wasn’t the sting of that moment; it was the outcome. Later, I learned they had done the hard work and found sobriety. It didn’t matter that it wasn’t with me; what mattered was that they found it.

That is not abandonment. That is refusing to collude with avoidance. That is saying, “I believe you can do the hard work, and I will not enable you to stay stuck. That’s not harshness. That’s care with boundaries. That’s compassion with a backbone.

The same applies to colleagues. If our field continues to indulge in hand-holding while demonizing anyone who dares to question its effectiveness, we’ll keep producing clients who are disillusioned, frustrated, and unchanged. And yes, if therapy is reduced to endless validation, then AI will replace us. Because algorithms can nod and soothe just as well as humans. And here’s the deeper danger: if therapy becomes indistinguishable from a chatbot, we’ve surrendered the very heart of our profession. What makes us human is our ability to integrate data, intuition, neuroscience, and compassion into a courageous alliance with clients, something AI cannot replicate.

But if we won’t step into that, why should clients stay?

The Cost of Avoidance

The pushback I receive, the mocking, the dismissive labels, only prove the point. Too many in this field would rather protect their egos than examine their effectiveness.

And if you truly believe in your effectiveness, why meet my challenge with defensiveness instead of dialogue?

And here’s the hard truth: thinking your methods work isn’t the same as proving they work. Our brains are wired with heuristic biases that let us believe we’re more effective than we are. We remember the “good sessions,” we block out the failures, and we rationalize when clients drop out. That’s not objective reflection, that’s bias.

Without data, “I feel like this helps” is just another soothing story we tell ourselves as therapists. And if we rely on those stories, we’re no better than the systems we criticize for keeping clients stuck.

Reflection is uncomfortable. Accountability requires humility. It means looking at outcomes even when they reveal discomfort, or worse, ineffectiveness. But without that discomfort, growth isn’t possible. And without growth, clients pay the price, stuck in cycles of professional hand-holding disguised as care. 

And let’s be clear: clients are paying twice. Once with their money and time, and again with their hope. Every ineffective session communicates: “You can’t change.” That message is devastating, and it’s the opposite of what our field was created to deliver.

Catching Flak and Refusing to Conform

This is why I keep writing the Catching Flak series. Yes, I take heat for my stance. But if catching flak is the cost of engaging in dialogue that challenges and builds our field, I’ll keep paying it.

Therapy should not be professional hand-holding. It should be structured, evidence-based, and compassionately courageous. It should integrate mind, brain, and body. It should be willing to measure outcomes and change course when the data demands it.

Real compassion doesn’t fear accountability. Real compassion demands it.

And that’s why I’ll keep speaking out, even if it earns me more laughing emojis. Because therapy that soothes for an hour but never transforms a life isn’t therapy at all. My vision is different. Therapy must return to being rigorous, measurable, and transformative. It must reclaim its role as a catalyst for growth, not a comfort subscription.

That’s what I’m fighting for, even when it means catching flak.