Why I Work Face-to-Face

For years, I worked both online and in person, and I have seen first-hand that remote therapy can be highly effective. For some, online therapy is the most practical and accessible option, and I fully acknowledge that it is the right choice for many individuals and therapists alike. However, as my practice has evolved, I have made the decision to work exclusively in person. This choice is not only a matter of preference—it is deeply rooted in my therapeutic approach, my areas of specialism, and the scientific research that underpins effective psychotherapeutic change.

The Neuroscience of Therapeutic Change

Face-to-face therapy provides a unique opportunity to engage with the relational and embodied aspects of psychotherapy in ways that are more difficult to replicate online. Neuroscientific research highlights the profound role of non-verbal communication, embodied presence, and nervous system co-regulation in the therapeutic process. One key area of interest is the role of mirror neurons, which are activated when we observe another person’s emotional and physical states. This mirroring capacity plays a significant role in empathy, connection, and relational healing, forming an essential part of therapeutic attunement. While some of this can be accessed remotely, the richness of shared physical space offers an additional layer of depth.

Immediacy, Embodied Awareness, and Co-Regulation

A cornerstone of my approach is immediacy—the process of working with what is happening in the room, in real time. This includes noticing shifts in tone, breath, facial expressions, and posture, all of which can provide vital insight into underlying emotions and relational patterns. The nervous system is constantly responding to our environment and to others around us, often outside of our conscious awareness.

When therapy takes place in person, we are able to track these shifts more precisely, allowing for a deeper awareness of how the body holds and processes emotion. This is particularly important when working with trauma, stress, and nervous system dysregulation, where the therapeutic relationship itself can provide an opportunity for co-regulation—the process of bringing balance and safety to an over-activated or shut-down nervous system through relational connection. Being physically present allows for a greater degree of attunement, helping to foster a sense of safety, trust, and containment that is essential for deep therapeutic work.

Transference, Countertransference, and the Relational Field

The in-person setting also enhances the ability to work with transference and countertransference—the emotional responses and unconscious relational patterns that emerge within the therapeutic relationship. These dynamics are at the heart of contemporary psychodynamic practice, providing invaluable material for understanding how past experiences shape present-day relationships. While countertransference can certainly be felt and explored in remote work, there is a richness to the embodied experience of sitting together in a room that allows for greater nuance and depth in these explorations.

Trauma and the Body

For women who have experienced trauma, in-person therapy offers an added layer of stability and containment. Research in somatic psychology and polyvagal theory suggests that trauma is not just a cognitive experience but is deeply held in the body. In the aftermath of trauma, the nervous system can become stuck in states of hypervigilance (fight/flight) or shutdown (freeze/collapse). Healing requires more than intellectual insight—it necessitates a felt sense of safety, attunement, and presence. Face-to-face therapy allows for an embodied therapeutic experience where we can work not only with thoughts and emotions but also with bodily awareness and regulation in a grounded, supportive space.

Why This Choice Matters

Ultimately, my decision to work exclusively face-to-face is about offering the best possible therapy based on my expertise, interests, and understanding of how deep psychological change occurs. It ensures that I can fully integrate embodied awareness, immediacy, relational depth, and nervous system regulation into my work. While online therapy is valuable for many, this is the setting in which I do my best work, and the one that allows me to offer the most to the women I support.

If you are considering therapy and feel drawn to this way of working, I invite you to get in touch for an initial consultation to explore whether face-to-face sessions might be the right fit for you.