Why your therapist shouldn’t ‘validate’ or ‘affirm’ everything you think.
Making the case for depth; why psychotherapy works best when it challenges.
In an era where mental health conversations increasingly emphasise affirmation and validation, a quieter but equally vital truth risks being overlooked; the most profound therapeutic change often emerges not from comfort, but from carefully guided exploration into the uncomfortable territories of our inner lives. Whilst validation certainly has its place in healing, the therapeutic encounter reaches its greatest potential when it ventures beyond surface-level support to engage with the complex, often contradictory landscape of human psychology.
Modern therapeutic culture has embraced the notion that people should feel consistently supported and affirmed. Whilst this represents a necessary correction to historically punitive approaches, it may inadvertently create new limitations. When therapy becomes primarily about validation, it risks becoming a sophisticated form of emotional comfort rather than a transformative process.
Pure affirmation can inadvertently reinforce the very patterns that brought someone to therapy in the first place. If an individual's presenting difficulties stem from unconscious conflicts, defence mechanisms, or deeply ingrained relational patterns, simply affirming their current perspective may provide temporary relief whilst leaving underlying structures unchanged (Gabbard, 2017). It's rather like treating a fever without addressing the infection, the symptom may subside, but the root cause remains intact.
The transformative power of therapeutic challenge
Effective psychotherapy operates on the principle that meaningful change requires more than understanding; it demands encounter. When a skilled psychotherapist offers gentle but persistent challenge to a person's assumptions, defences, or patterns of relating, they create space for new possibilities to emerge.
This isn't about confrontation for the sake of it, but about creating what psychoanalyst Donald Winnicott termed "optimal frustration"; enough challenge to promote growth without overwhelming the individual's capacity to process and integrate new insights (Winnicott, 1965). The therapeutic relationship becomes a laboratory where old patterns can be safely examined, and new ones tentatively explored.
Consider the person who repeatedly finds themselves in destructive relationships. Whilst validation of their pain is essential, lasting change requires exploring the unconscious dynamics that draw them to these patterns. This might involve examining early attachment experiences, understanding how they recreate familiar dynamics, or confronting the ways they might unconsciously contribute to their own difficulties.
On depth, transference and the unconscious
Psychodynamic psychotherapy and psychoanalysis offer unique advantages through their emphasis on transference; the tendency to unconsciously transfer feelings and patterns from past relationships onto the therapeutic relationship. Rather than viewing this as a problem to be managed, depth approaches recognise transference as the path to understanding and transformation.
When a person becomes frustrated with their psychotherapist's silences, or feels abandoned by holiday breaks, or experiences the psychotherapist as critical despite evidence to the contrary, they afford the process valuable information. Through this we can learn about the internal templates through which they experience relationships (Fonagy et al., 2004). These moments provide direct access to the unconscious patterns that shape their lives outside the consulting room.
The psychotherapist's role becomes that of a skilled archaeologist, helping to excavate these buried patterns and bringing them into conscious awareness where they can be examined, understood, and ultimately transformed. This process requires time, patience, and a willingness to tolerate uncertainty; qualities that sit uncomfortably with our culture's preference for quick solutions and immediate relief.
Therapeutic frame, safety & structure
Depth psychotherapy creates safety through the provision of a reliable therapeutic frame, not through constant reassurance. Regular sessions, consistent timing, and the psychotherapist's disciplined attention to the process (rather than just the content) create what psychoanalyst Christopher Bollas calls "the unthought known"; a sense of containment that allows the person to venture into previously unexplored territory (Bollas, 1987).
This containment enables regression in service of progression. Individuals can temporarily revisit earlier developmental stages, not to remain there, but to rework unfinished business and emerge with greater integration and maturity. The psychotherapist's capacity to tolerate and work with primitive emotions, defences, and ways of relating provides a corrective emotional experience that purely supportive approaches cannot match (Alexander & French, 1946).
Evidence & effectiveness
Research consistently demonstrates that longer-term psychodynamic therapy produces structural personality change that continues to develop even after therapy has ended (Shedler, 2010). The 2008 Shedler meta-analysis showed that psychodynamic therapy produces benefits that actually increase over time; a phenomenon less evidenced in other therapeutic modalities.
This enduring change reflects the depth dimension of psychodynamic work. Rather than simply managing symptoms or providing coping strategies, depth psychotherapy addresses the underlying psychological structures that generate symptoms (Leichsenring & Rabung, 2008). Like the difference between repeatedly mopping a floor that’s flooded, or repairing the pipe that’s leaking onto the floor in the first place.
The courage to go deep
Modern life often encourages us to move quickly past discomfort, to seek immediate solutions, and to avoid the messy complexity of our inner lives. Depth psychotherapy asks something different: it invites us to slow down, to sit with uncertainty, and to discover that our symptoms and difficulties often contain important information about our deepest needs and conflicts.
This process requires courage from both individual and psychotherapist. The person must be willing to question long-held assumptions about themselves and their relationships. The psychotherapist must resist the temptation to provide premature comfort or superficial solutions, instead maintaining what psychoanalyst Wilfred Bion called "negative capability"; the ability to remain with uncertainty and not-knowing until genuine understanding emerges (Bion, 1970).
This isn't an argument against validation or supportive interventions when they're needed. Rather, it's a case for recognising that true therapeutic healing requires a delicate balance between support and challenge, between holding and letting go, between affirming what is and exploring what might be.
The most effective psychotherapists understand that timing is crucial. Early in therapy, or during periods of crisis, validation and support may be paramount. But as the therapeutic relationship deepens and the individual's capacity for self-reflection develops, the work can move into more challenging territory where real transformation becomes possible (Luborsky, 1984).
Conclusion: the irreplaceable value of depth
In our rush to make mental health services more accessible and immediate, we risk losing something essential; the recognition that some forms of human suffering require more than quick fixes or surface-level interventions. The deep patterns that shape our lives, our ways of loving, working, and relating, were formed over many years and often require sustained, skilled attention to transform.
Psychodynamic psychotherapy and psychoanalysis offer something unique in the therapeutic landscape: a method for engaging with the full complexity of human psychology in service of genuine transformation. They remind us that the goal of therapy isn't simply to feel better, but to understand ourselves more deeply and to live more authentically.
In a world that often feels increasingly superficial, depth psychotherapy stands as a testament to the enduring value of looking beneath the surface. It asks us to trust that our symptoms and struggles contain wisdom, that our resistances often protect something precious, and that true healing requires not just comfort, but the courage to encounter ourselves fully.
The journey inward is never easy, but for those willing to undertake it with a skilled guide, it offers the possibility of change that reaches to the very roots of who we are. In the end, this may be the most affirming therapeutic stance of all: the belief that human beings are complex, resilient, and capable of profound transformation when given the right conditions in which to explore the depths of their own experience.
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References
Alexander, F. and French, T.M. (1946) Psychoanalytic therapy: Principles and application. New York: Ronald Press.
Bion, W.R. (1970) Attention and interpretation. London: Karnac Books.
Bollas, C. (1987) The shadow of the object: Psychoanalysis of the unthought known. New York: Columbia University Press.
Fonagy, P., Gergely, G., Jurist, E. and Target, M. (2004) Affect regulation, mentalization, and the development of the self. London: Karnac Books.
Gabbard, G.O. (2017) Long-term psychodynamic psychotherapy: A basic text. 3rd ed. Arlington, VA: American Psychiatric Publishing.
Leichsenring, F. and Rabung, S. (2008) 'Effectiveness of long-term psychodynamic psychotherapy: A meta-analysis', Journal of the American Medical Association, 300(13), pp. 1551-1565.
Luborsky, L. (1984) Principles of psychoanalytic psychotherapy: A manual for supportive-expressive treatment. New York: Basic Books.
Shedler, J. (2010) 'The efficacy of psychodynamic psychotherapy', American Psychologist, 65(2), pp. 98-109.
Winnicott, D.W. (1965) The maturational processes and the facilitating environment. London: Hogarth Press.
Very interesting to read about Shedler meta-analysis and that idea that personality reorganisation is being tracked following the end of therapy. Often in psychotherapy research circles we defer back to the ‘Dodo Bird’ finding - that ultimately the modalities have similar outcomes and that other factors, such as the competency of individual therapists, may be at least as important. But the logic of substantial change under a psychodynamic approach really makes sense - like ‘teach a man to fish’.
I thought about how often counselling skills training can leave practitioners with skills squarely in the validation zone, and that often the ‘optimal frustration’ that we create through challenges develops beyond clinical training - perhaps that’s how it should be, safety first.
Love the metaphor of therapist as archaeologist.