Feeling It With You
What Empathy Actually Is in the Therapy Room
There is a difference between being understood and being felt. Most of us have experienced the first ~ someone listening carefully, nodding, reflecting back what we said in accurate language. It can be helpful. But it is not the same as the second.
Being felt is something different. It is when you sense that the person across from you is not just tracking your words but is somewhere inside the experience with you ~ that your pain has landed in them, not just been registered by them. It is rarer. And when it happens, something shifts that no amount of accurate understanding can produce on its own.
Empathy is the subject of the third episode in Dr. David Puder’s therapeutic alliance series, and it is one I keep returning to ~ not just as a clinical concept, but as something I am still learning to deepen in myself and in my practice.
Two kinds of empathy ~ and why both matter
Puder distinguishes between cognitive empathy and affective empathy. Cognitive empathy is the capacity to understand what someone is experiencing ~ to take their perspective, follow their logic, make sense of their inner world. Affective empathy is something closer to resonance ~ actually feeling what they are feeling, the emotion moving through you as it moves through them.
Carl Rogers described it this way: to sense the hurt or pleasure of another as they sense it, to perceive the causes as they perceive them ~ but without ever losing the recognition that it is as if you were the one feeling it. That “as if” is doing a lot of work. It keeps the therapist present and grounded rather than overwhelmed. But the feeling itself has to be real.
I think about this often. The goal is not to perform empathy from a safe distance. It is to actually go there with someone ~ and to stay regulated enough that they never have to take care of you in the process.
What it feels like when it is real
I had a client who had experienced a significant loss. We had been working together for some time, and this was the session where they finally went there ~ really went there. As they spoke, something happened in me that I can only describe as weight. A heaviness. Something that felt like grief, not my grief exactly, but something close enough to it that it was unmistakable.
I did not perform sadness. I held what was arising in me the same way I was trying to hold them ~ with care, with steadiness, with respect for the enormity. And something in that holding broke something open between us. They felt it. They knew I was in it with them, not watching from outside it. The sessions went deeper from that point on, consistently.
I am careful about matching intensity. A client should never feel that they have to hold me ~ that their pain has become my burden and now they are managing both. The attunement has to serve them. But there is a difference between that caution and keeping oneself clinically sealed off. People can feel the difference. They always can.
There is something I come back to when I sit with someone in real pain ~ the simple fact that we are all on a spinning ball circling a ball of fire, navigating this brief and often bewildering experience of being alive. Held inside that perspective, almost everything a person is carrying makes sense. Almost everything deserves to be felt.
On being invisible ~ and learning to see yourself
Puder shares research on what happens to medical students when their supervisors are disconnected ~ not in life-or-death situations, but in ordinary moments of being overlooked. Students described feeling invisible, worthless, not worth the senior’s attention. And the research is clear: it is not the difficult cases that burn people out. It is the quality of the relationships above them.
That finding landed in me personally. I spent much of my childhood feeling invisible. Third in birth order, in a household where my parents were stretched ~ there simply was not enough left for me most of the time. At school I moved through without much notice, never quite part of a group, finding my depth in one or two close connections rather than belonging to something larger.
What I did not understand then was that I was also invisible to myself. I did not have language for what I was experiencing ~ or a way to reach it. That began to change in my early twenties, at a Vipassana meditation retreat. Ten days of silence, moving from breath awareness to sensation on the upper lip to a full body scan. No movement, just listening. It was the beginning of building a muscle I did not know I needed ~ the capacity to stay with what was happening internally without immediately reacting to it or pushing it away.
But Vipassana alone was not the complete picture. It trained one specific thing: the mind’s ability to focus on the body. What I discovered later, in IBP ~ Integrative Body Psychotherapy ~ was that the body also needs to move, to release, to complete what it started. Both things together ~ the stillness and the movement, the listening and the letting go ~ that is where real integration happened for me.
Once I started to see and hear myself more clearly, I could see my parents differently too. They became more human, more understandable. A chronic low-grade blame that I had been carrying began to lift. I made deeper connections, longer friendships. I felt lighter walking through what is, at times, a genuinely heavy world.
I say this not to centre myself in someone else’s story. I say it because I think it matters that the person sitting across from a client has done this work ~ has some felt understanding of what it is to be unseen, and what it takes to begin seeing oneself. That is not something you can read your way into.
Three levels of being with someone
Puder describes empathy as moving through layers. The first is noticing the emotion ~ the flash across the face, the shift in posture, the change in voice. Simply registering: something is here.
The second is understanding that emotion in the context of someone’s life. Not just what they are feeling now, but where it comes from ~ the experiences, the history, the patterns that made this particular feeling make sense. This is where the work deepens, where a session moves from surface to something more substantial.
The third level is the most delicate: the emotion as it lives in the relationship between client and therapist. What is happening between us, right now, in this room. That is powerful territory ~ and it requires that the space has been built carefully enough to hold it.
I am still learning to move more fully into that third level. In reflecting on some of my sessions, I can see moments where I moved toward identifying or problem-solving when what was needed was to stay longer in the context ~ to understand more deeply before offering anything. That is honest, and I think it is worth saying. The work of becoming a better therapist is not finished. It is ongoing, session by session.
This is not a usual social situation
There is a quote from Dr. John Tarr, the ninety-year-old psychoanalyst who mentored Puder, that I have been sitting with since I first heard it:
“I hope you can understand that this is not a usual social situation where you don’t tell people negative thoughts. Here, I hope you have the courage to say them out loud.”
That is something I want to bring into every initial consultation I have from here forward. Not as a technique ~ as an invitation.
Say what feels unseen. Say what feels wrong. Say your resistance out loud. Even say your silence out loud by not saying anything, if that is what is true in the moment. This space is built to hold all of it ~ including whatever you feel about me, about the process, about whether any of this is working.
That kind of openness is not a vulnerability in the therapeutic relationship. It is the foundation of it. It is what turns a series of appointments into something that can actually change things.
If you recognise something here
If you have spent time feeling unseen ~ by others, or by yourself ~ and you are curious about what it might be like to be genuinely felt rather than just understood, I would be glad to talk.
The free discovery call is a good place to start ~ no pressure, no commitment. Book one here. I work with individuals and couples online across British Columbia.
Published May 2026 | Updated July 2026
Cyrus Jagosh, RTCc (ACCT) | MPCC-P (CPCA) — Registered Therapeutic Counsellor (Candidate) at Cyrus Counselling, offering individual and couples therapy online across British Columbia. He draws on trauma-informed, somatic, and relational approaches.
This post is written for general informational purposes and does not constitute clinical advice. If you are in crisis or need immediate support, please contact a crisis line or emergency services.
This is part of an ongoing series on what makes therapy work.