Should Psychotherapists Promote Real-World Relationships?

Why therapists should consider connection as the goal, not just the context.

In a globalised world increasingly defined by displacement, isolation and non-stop digital communication, a difficult question arises: Should psychotherapists actively promote real-world relationships as a cornerstone of treatment?

Neuroscience, attachment theory, developmental psychology, and trauma theory converge on one truth: human beings are relationally wired. The nervous system co-regulates in contact with others. Emotional regulation, identity development, and meaning-making all take shape in relationships. But knowing that relationships matter is not the same as treating them as clinical priorities.

In some therapeutic spaces, encouraging behavioural engagement is seen as intrusive. There's a reluctance to be directive. The therapist may fear that this risks “pushing” a client, or implying that growth must look a certain way. This often stems from compassion. But compassion without direction can stall change.

While insight often facilitates real-world change, sometimes this is not enough to result in relational action. A client may explore their inner world for considerable time without ever practising a new response in the outer one. They may learn to name a fear of rejection but never take the risk of feeling rejected. They may uncover attachment wounds but remain locked in avoidance or pseudo-independence.

In these cases, withdrawal is not just a symptom, it's part of the problem. Avoidance becomes a mechanism of psychological maintenance, reinforcing beliefs that closeness is dangerous and people are not to be trusted. It imprisons the client, offer contributing substantially to their suffering. 

This is where I question if therapy and relationships must intersect? The question is not do relationships matter? but what is our clinical responsibility when a client remains socially disconnected? Should we address avoidance as resistance? Should we contract around behavioural activation not just symptom relief, but functional re-entry into the world?

Avoidance may be understandable. But left unchallenged, it becomes existential. Therapy must wrestle with this tension: What makes life livable is also what makes it hard. Without meaningful engagement with other people (where we must embrace responsibility and tolerate difference), mental health becomes theory, not practice.

The Real World as a Therapeutic Arena

Psychological wellbeing is not cultivated in abstraction. It is shaped and tested in the messy, uncertain spaces of real life, workplaces, families, friendships, and everyday conflicts. While insight is a valuable tool, it is not the same as change. Knowing why we feel stuck doesn’t always help us move. Real change often begins when we do something differently and stay long enough in that discomfort to learn.

Clients may come to therapy with the hope that understanding themselves will be enough to bring relief. And sometimes, it does. But for many, emotional clarity alone does not shift long-standing relational patterns. Despite knowing their fears are irrational, they still avoid closeness. Despite recognising their coping mechanisms are outdated, they continue to repeat them. This is not laziness or resistance—it is the mind defending against perceived threat.

In this context, therapy becomes more than reflective dialogue. It becomes preparation for action. The therapist helps the client identify where avoidance has taken root and how it reinforces emotional stagnation. Together, they begin to imagine what re-engagement might look like—not in theory, but in concrete, behavioural terms.

This is not about prescribing friendships or telling clients how to live. It is about anchoring treatment goals in the realities of daily life. For many people, relational engagement—reaching out, tolerating disappointment, staying present in conversation—is not a default skill. It must be built, step by step, through intentional effort and supported experimentation.

Therapy, then, becomes both sanctuary and launchpad. A place to recover safety, but also to practice risk.

Supporting Real-World Engagement Without Forcing Connection

Therapy must tread the line between safety and stretch. While it should never become a coercive space, neither should it become a sanctuary of stagnant or permanent retreat. Real-world change requires risk and the willingness to experiment with being seen, being known, and sometimes, being wrong.

For clients with histories of trauma, neurodivergence, or personality-based challenges, connection is often experienced not as a comfort, but as a threat. Their nervous systems may react to intimacy with fight, flight, freeze or fawn. In these cases, therapeutic encouragement must be paced, thoughtful, and attuned. But it must still be active.

The goal is not to push people into social settings, but to help them notice and name the protective strategies that have become rigid. Emotional withdrawal, perfectionism, idealisation, control, avoidance are all patterns that may once have been adaptive. But now they may be costing the client their sense of belonging, intimacy and growth.

Therapists can support clients to:

• Develop a more stable and integrated sense of self that can tolerate difference and disappointment

• Understand how their internal working models affect relational responses

• Identify where avoidance is no longer serving them

This is not a mandate for social success. It is an invitation to rejoin the human community, on their own terms, with greater freedom.

The relational world is not always kind, but neither is isolation. And if therapy never challenges the client’s relational patterns, we risk reinforcing the very disconnection they came to resolve.

Should Therapists Promote Real-World Change?

While few would dispute that real-world relationships are fundamental to mental wellbeing, many therapists hesitate to make this a treatment goal. They worry that encouraging behavioural change might feel directive, invalidating, or even re-traumatising. Some hold tightly to the belief that therapy is a space for reflection, not action. They may also secretly fear an overt challenge to the status quo. 

But there is a cost to this caution.

When clients speak of loneliness but avoid connection, when they express longing but resist vulnerability, we are not dealing with preference, we are witnessing avoidance. And avoidance is not benign. It is a stance that shapes identity, entrenches dysregulation, and reinforces narratives of helplessness or unworthiness.

So the question becomes: Is it ethical to witness a client’s relational suffering and not challenge the patterns that sustain it?

Therapy is not a neutral container. It is a relational intervention. And relational growth requires movement.

That doesn’t mean prescribing relationships or pushing clients into premature intimacy. It means being willing to name the gap between desire and action and to ask what stands in the way of connection and how those obstacles might be addressed.

This is the clinical stance that distinguishes empathy from enablement. It recognises that psychotherapy goals must include more than insight. They must also promote emotional growth, real-world engagement, and behavioural change in therapy.

At its best, therapy is not a holding bay for pain. It is a platform for transformation.

Closing Thoughts

Returning to the initial question: what role should therapy play in helping people build and sustain relationships?

It feels objectively true that relationships matter, not just as sources of comfort, but as regulators of emotion, builders of identity, and markers of meaning. Should we, as therapists, contract around real-world relational change? Should we challenge clients who retreat from the world, not to be harsh but because we believe in their capacity to connect? Should we position therapy not as a sanctuary, but as a springboard?

In the end, the need for connection is neither a flaw nor a luxury. It is a core part of what makes us human. The task, in therapy as in life, is not to erase that need, but to learn how to meet it more safely, flexibly and fully.

Written by Kirstan Lloyd, Clinical Psychologist

 Founder of the Helix Centre, a UK-based psychology and psychotherapy practice specialising in neurodiversity, mental health, and therapeutic assessment. This article was written by Kirstan with the support of AI research tools and is grounded in recent literature from psychology, neuroscience, and trauma-informed care.

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(Note: References were used for conceptual framing and clinical accuracy. This is not an academic article.)