Most of us enter therapy hoping to feel better – less anxious, less burdened, more ourselves. Often, the therapy room becomes a haven: a warm light, a calm voice, a ritual of reflection. It’s safe. Predictable. Thoughtful.
But real life isn’t like that.
Real life is awkward, intense, messy. People misread us. We lose our cool. There’s judgment, silence, withdrawal, interruption, emotional overload.
So, here’s a question worth asking:
Are we rehearsing for real life in therapy – or just talking about it from a safe distance?
From Glass Box to Living System
In medical science, in vitro refers to what happens in a lab – petri dishes, test tubes, sterile environments. In vivo means “in life”, where things are messy, unpredictable. A medical breakthrough has no value until it is tested in vivo.
The same is true in therapy.
New knowledge, a fresh perspective, or talking about changing an old habit, has little value unless it can be tested in real-life – or in a setting that stirs up real-life emotion and dysregulation.
The gritty, productive edge of therapy is where we feel the vulnerability, the bracing, the freeze, but our therapist stays present, consistent, and gets us back safely to the other side. This not only tests and hones our skill, it models a functional way to be with strong emotion in relationship – raising the bar on what we ask, expect, or demand accountability for, in others.
Imagine sitting with your therapist, your chest tight, angry words rising. The instinct is to smooth it over. Instead, they say, “Let’s stay with this”. Now you’re not describing anger, you’re in it, and supported through it.
The Value of In Vivo Experience
Therapy that leans into in vivo work means:
- Feeling emotions in real time – not just describing them.
- Noticing when safety ruptures (especially a subtle rupture) and finding your way back.
- Sitting with discomfort, irritation, or pushback, with full awareness of what’s happening in your body.
- Letting the therapist be human – because the world is full of humans.
Imagine: You share something vulnerable, your therapist glances at the clock. For a second, you feel dismissed. The warmth drains out. You want to shut down. They catch it. Meet your eyes. “I want to stay with this”. That’s rupture and repair. Not theory. Practice.
The world doesn’t always wait for us to be ready. If therapy is too sanitised, it can create a false sense of security. Then the rawness of daily life feels like failure, rather than simply… life.
Therapy as Relationship
All relationships include misattunements – moments of disconnect, confusion, or impact. The difference in therapy is that a well-trained, self-aware therapist won’t abandon you there. Instead, they’ll say, in their words or actions, “I’m still here. We can come back from this.”
And every time that happens, your nervous system learns something priceless:
That rupture doesn’t mean ruin. That conflict doesn’t equal danger. That you can survive being seen. And that’s not just therapeutic – it’s transformative.
Imagine: Your therapist interrupts. Irritation flares. Instead of brushing past, they pause: “I cut you off. Let’s go back.” In that honesty, you learn imperfection doesn’t end connection. It can deepen it.
“Safety is not the absence of threat; it is the presence of connection.” – Gabor Maté
For Your Journey
If you’re in therapy, or considering it, it’s okay to want more than comfort. It’s okay to want truth. To want to feel something real. To want a space where you can risk being known – and where the work feels alive.
Because healing doesn’t just happen in the calm. It happens in the fire, too.
And sometimes the most valuable therapy isn’t the one that feels nice…
but the one that helps you live.