Who Holds the Truth? Exploring Constructivist vs. Objectivist Therapies in the Therapy Room

When you walk into a therapy session, who is the expert in the room? Is it the therapist—trained in diagnosis, treatment plans, and mental health frameworks? Or is it you—the person living in your own skin, carrying a lifetime of experiences, beliefs, and meanings? How this question is answered says a lot about the kind of therapy you’re engaging in—and what kind of healing becomes possible.

In this post, we’ll explore the differences between constructivist and objectivist therapy approaches, and how each shapes the therapeutic relationship, the role of the client, and what we consider to be “problems” in the first place.

Objectivist Therapies: Diagnosing, Fixing, and Treating

Objectivist therapies are grounded in the idea that there is an objective reality about human behavior, mental illness, and appropriate treatment. This approach assumes that psychological issues can be identified, categorized, and treated using standardized methods—much like medical conditions.

Examples include:

• Cognitive Behavioral Therapy (CBT)

• Dialectical Behavior Therapy (DBT)

• Exposure Therapy

• Psychiatric diagnostic models (DSM-based)

In these therapies:

• The therapist is often positioned as the expert.

• The client’s distress is framed as a symptom of a disorder or faulty pattern.

• The goal is symptom reduction or behavior correction.

• Problems are often viewed as maladaptive, irrational, or dysfunctional.

Implications: This can be incredibly helpful for some people—especially those looking for structure, concrete tools, or support in crises. But it can also reinforce power imbalances. The therapist may be seen as the authority on what’s “wrong” and what needs to be done to fix it.

For clients who have experienced medical trauma, marginalization, or invalidation, this model can feel disempowering, especially if their suffering is pathologized without deeper exploration of its context or function.

Constructivist Therapies: Meaning-Making, Context, and Collaboration

Constructivist therapies, on the other hand, start from the idea that there is no single objective reality. Instead, we all create meaning based on our experiences, relationships, and internal narratives. Emotional pain isn’t always a symptom of a “disorder”—it’s often a response to real, lived experiences.

Examples include:

• Narrative Therapy

• Coherence Therapy

• Internal Family Systems (IFS)

• Existential Therapy

• Emotion-Focused Therapy (EFT)

In these therapies:

• The client is viewed as the expert of their own experience.

• The therapist acts more as a collaborator or guide than an authority.

• Symptoms are understood as adaptations, not malfunctions.

• The focus is on why the problem makes sense, not just on changing it.

• Healing comes through awareness, reconnection, and transformation of meaning.

Implications: This approach de-centers the therapist’s authority and instead centers collaborative curiosity. It invites the client to consider: “What is this reaction trying to protect me from? How did it help me survive? What meaning have I given to these experiences?”

This opens a door to therapy that is non-pathologizing, trauma-informed, and deeply validating.

Power Dynamics: Who Gets to Define the Problem?

In objectivist therapies, power often flows from therapist to client. The therapist diagnoses, instructs, or corrects. This isn't inherently bad—many people want and need clear guidance at certain points in their healing journey.

But for others, particularly those recovering from environments where their experience was routinely dismissed or controlled (e.g. childhood trauma, abuse, systemic oppression), this dynamic can feel retraumatizing.

Constructivist therapies attempt to equalize the relationship. The client’s story isn’t analyzed—it’s honored. The “problem” isn’t decided by diagnostic criteria—it’s explored through the client’s lens of meaning, emotion, and survival.

In this way, therapy becomes a co-created space, where trust is built through mutual respect and discovery.

What Happens When Symptoms Are Seen as Strategies?

One of the most powerful shifts in constructivist therapy is viewing emotional and behavioral struggles not as errors—but as strategies.

• Anxiety? Maybe it’s the nervous system’s way of staying safe in a world that’s felt unpredictable.

• People-pleasing? Perhaps it was a necessary skill to avoid emotional abandonment.

• Perfectionism? It may have helped someone feel worthy in a home where love was conditional.

Rather than aiming to get rid of these patterns through willpower or skills training, constructivist therapy invites us to understand their origin and function. Once the underlying emotional needs are identified and addressed—through experiential processes that lead to memory reconsolidation—the pattern often resolves on its own.

Memory Reconsolidation & Experiential Change

Constructivist approaches often use experiential therapy techniques to engage not just thoughts, but emotions, body sensations, and implicit memories.

One of the key mechanisms at work is memory reconsolidation—a neurobiological process in which the brain updates old emotional learnings with new, contradictory experiences. This doesn’t just manage symptoms—it can permanently dissolve them at the root.

This work often happens through:

• Revisiting emotionally charged memories in a safe space

• Making sense of the emotional logic of past adaptations

• Creating new, healing experiences that contradict the original emotional learning

So, Which Approach Is Right?

There’s no one-size-fits-all answer. Many therapists draw from both schools of thought depending on your needs, goals, and preferences. But understanding the underlying framework can help you make more informed choices about your healing.

Ask yourself:

• Do I want practical tools to manage my symptoms, or am I looking for deeper emotional transformation?

• Do I feel safe in a structured, directive setting—or do I need more space to explore my story without judgment?

• Do I want someone to tell me what to do, or someone to help me discover what’s meaningful to me?

Final Thoughts: Honoring Your Lived Experience

At the end of the day, good therapy doesn’t impose a truth on you—it helps you uncover your own.

Whether your healing happens through cognitive skills, emotional exploration, or both, you deserve a space where your symptoms aren’t shamed, your coping isn’t pathologized, and your story is respected.

You are not broken. You adapted. And now, you get to choose something new—with the right support by your side.