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North London, NHS Foundation Trust

What Makes a Good Therapist?

In this article, Psychodynamic Psychotherapy course lead, Rodrigo Sanchez, explores some of the personal characteristics which can support students in clinical training.

Explainer

Training to become a psychotherapist is a journey of learning and self‑discovery, as much as it is about learning new skills. It is a process that involves connecting with parts of ourselves that we might resist acknowledging, as well as some we were not even aware of.

Theoretical knowledge and clinical techniques are essential, but they come from a deeper development of human qualities. These qualities shape how a therapist listens, thinks, and stays emotionally present with another person during therapeutic work.

Curiosity about your inner life

Self-knowledge is the starting point for clinical work. Effective therapists are eager to explore their own history, vulnerabilities, emotions and reactions with curiosity, rather than defensiveness. This is not self-indulgent; it is the groundwork for clinical sensitivity and the ability to notice what is happening in the therapy room. Subjectivity is inevitable in therapeutic work, but the more self‑aware the therapist is, the less likely they are to confuse their own responses and limitations with the patient’s difficulties.

When a therapist has examined their own triggers and insecurities, they can recognise when a feeling in the room belongs to the patient, when it is their own, and when it is a mixture of both. That self-awareness allows them to stay steady, think about their experience, and use it to understand the patient rather than react to them. Personal therapy and curiosity about one’s own life sharpen this capacity and turn the therapist’s internal world into a useful instrument for clinical work.

Being socially attuned and emotionally approachable

Emotional availability and social skills matter as much as a neutral stance. Therapists who develop their capacity to read social cues, to make others feel safe, and to invite interaction are more likely to help patients settle and feel comfortable in the therapeutic work. Warmth and a grounded presence ease the first steps of treatment, allowing people to feel safe and welcome.

This does not require extroversion or cheerfulness. It requires a presence that invites honesty, reflection, and trust – a human and accessible presence that goes beyond the role. Similarly, effective therapists demonstrate a way of caring that goes beyond technical elements and embraces the work with honesty and genuine emotional availability for others. We can teach the technical elements of therapy, point to the right books, and explain the theories, but it is much harder to teach someone how to listen deeply to another, to tolerate being with them in a caring way when they are being difficult, and respond genuinely, even if it is just through a gentle facial expression at the right time. Subtle intuitions guide the therapist as to when to remain silent, when to speak or soften one’s tone, and when to offer sympathy. This way of being in the room does not arise from observation alone, it comes from a deeper emotional capacity that varies from person to person.

A genuine capacity for care

Caring cannot be manufactured. The ability to feel concern for another person’s suffering is central to psychotherapy. Some people arrive already attuned to others’ emotions. Others develop empathy through their own personal work. Emotional sensitivity matters. If emotional pain in others overwhelms you or leaves you cold, this may signal the need for further personal development before beginning training. Therapists who respond defensively, or who feel flooded or overly disturbed by another person’s distress, will struggle to offer the steady, containing presence that clinical work requires. At the same time, to not be moved by our clients and patients can make therapy meaningless. At its heart, psychotherapy depends on the therapist’s emotional availability, steadiness, and authentic investment in the patient’s wellbeing.

Placing the patient’s needs first requires emotional maturity. Therapy is a two-person process, but the therapist must be able to tolerate being misunderstood, criticised, or excluded without retaliating or shutting down. That tolerance allows the therapist to protect the work and to think rather than react. At the same time, therapists need to be honest with themselves (and their supervisor) about how they are feeling. If they notice irritation, anger, or even a sense of not looking forward to seeing a patient, it is important that they can face the real experience, rather than trying to always be a “good” person.

Staying emotionally engaged while setting aside immediate personal reactions is demanding. It means pausing, reflecting, and holding difficult feelings in mind. Therapists who can be “second” in the room, who can remain present when they feel left out, are better able to understand what the patient is communicating, and to respond in ways that deepen the work.

The ability to tolerate uncertainty

Therapists who feel compelled to know, to be right, or to treat theory as absolute truth often close down the very space where thinking can happen. Psychoanalytic work depends on the willingness to sit with what is unclear, contradictory, or not yet understood. When a therapist can hold this uncertainty, rather than rushing to find an explanation, they create room for the patient’s experience to unfold on its own terms. This stance is not a lack of knowledge; it is a disciplined openness, a commitment to discovering meaning rather than assuming it.

Since Wilfred Bion’s time at the Tavistock, a distinctive clinical culture has taken root: the commitment to facing the unknown as a space for discovery, rather than rushing to diagnose or to match the patient to what we already think we know. Bion’s emphasis on approaching each session “without memory or desire” shaped generations of clinicians here, encouraging therapists to encounter the patient not as a fixed story but as a continually unfolding experience. This ethos – treating each session as a fresh opportunity to rediscover the patient – has become a signature of our training. It protects the work from theoretical rigidity and keeps the therapist open, curious, and receptive to what is emerging in the moment.

Training, personal work, and professional longevity

Training transforms potential into practice. The qualities described above are not prerequisites that must be perfectly developed before training begins. They are starting points that training and personal therapy cultivate. Learning to work with projection, countertransference, and emotional intensity is essential to sustain a career in mental health.

The 2023 Psychological Professions Workforce Census reported a turnover rate of 16% for psychological therapists, notably higher than the NHS average of 10%. Additionally, research shows that therapists adhering strictly to NICE guidelines experience elevated burnout levels (Ryan, Duncan, & Moller, 2019), underscoring the emotional demands of therapeutic work. On the other hand, psychoanalysts tend to retire later in life and often continue to find meaning and satisfaction in the challenges of being emotionally present for others. This endurance is supported by a deep awareness of how the work affects them personally, allowing them to engage in ongoing self-reflection and personal development to sustain their emotional availability over time.

At Tavistock Education and Training, our courses focus on the human capacities that make clinical work possible. We train therapists to stay close to suffering, to tolerate not-knowing, and to think deeply about human experience. We emphasise personal therapy, reflective supervision, and relational understanding, rather than quick fixes or purely technical solutions.

Our Master’s Degree in Psychodynamic Psychotherapy supports trainees to develop the emotional capacities required of a therapist, not just theoretical knowledge. Through experiential groups, case discussions, and workshops, trainees learn to recognise how a patient’s history may affect them and how their own subjectivity shapes the therapeutic encounter. We treat the therapist’s emotional presence as central to clinical practice and design the training to help students cultivate the personal qualities they bring into the room.

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