Why In-Person Therapy Is Better Than Telehealth

Telehealth has expanded access to care, but something essential gets lost through the screen. In-person therapy offers what technology can’t replicate: real presence, shared space, and the healing power of being truly seen.

Long-Distance Love

Have you ever been in a long-distance relationship?

I have.

For two and a half years before Katie and I got married, we lived on opposite sides of the country—California to South Carolina. We met during college on a summer trip, fell in love, and then spent years learning how to love through distance.

It was weird, awkward, and hard. We made it work, and it worked out—but it wasn’t easy.

Keeping that connection alive across time zones felt like trying to hold water in open hands. I missed her more than I connected with her. And when we did talk, it was through a phone or a glowing screen.

It required translation.

I didn’t really hear her voice—I heard a speaker playing a sound from a receiver thousands of miles away. It sounded like her, but it wasn’t her. It was a version of her.

That’s the best way I can describe telehealth.

The Boom of Accessibility

Telehealth has changed the field of therapy. It has opened the door wider than ever before.

People who once couldn’t access therapy—parents, shift workers, people in rural areas—can now log in from their bedrooms, cars, or offices.

More couples are seeking support because they can fit sessions into their day:
one partner on a lunch break, the other home with the kids, a therapist on a screen trying to hold a sacred container for intimacy and truth.

That accessibility is a gift.

But it’s a gift with a cost.

The Cost of the Screen

The ease of telehealth has changed the work. It’s not worse—it’s different.
Clunkier. More detached. Motivation shifts. The sense of being seen and felt changes.

Good work can still happen. Deep work, even. But it’s long-distance therapy.

You’re not actually in the same space.
You’re not hearing the person’s voice—you’re hearing a digitized, compressed version of it.
You’re not seeing them—you’re seeing light translated into pixels, a few milliseconds delayed.

It’s still connection, but through translation.

And translation always loses something.

The Presence of the Room

In-person therapy is built around presence.
The work lives in breath, in silence, in the hum of two nervous systems learning to co-regulate in real time.

There’s something ineffable about being in the same room with another human being—sharing the same air, hearing the small sounds, seeing the subtleties that no camera catches.

Presence communicates what words can’t.
It says, You are here. I am here. We exist together.

That alchemy doesn’t happen the same way through a screen.
It can’t.

Telehealth is like a long-distance relationship.
Sometimes it’s what needs to happen.
Sometimes it’s the only way love—or healing—can survive.

But it’s not the same as being together.
And it never will be.

A Space to Come Home To

At Sacred Work, we built our practice around a simple belief: healing deepens when two people share real presence. Our office in Sausalito was created intentionally—soft light, calming colors, a room that feels safe enough to breathe—because environment shapes what becomes possible.

Individuals and couples come in carrying all kinds of stories: stress that’s been building for years, grief that hasn’t had space to land, questions about identity or purpose, relationships that feel tender or stretched thin. And something shifts the moment they settle into the room. Their shoulders drop. Their breath changes. The space begins to hold what they’ve been holding alone.

In person, the work unfolds differently:

• Your body relaxes in ways it can’t through a screen.

• Subtle emotions and expressions come through more clearly.

• Silence feels supportive instead of awkward.

• You feel met—fully, directly, without translation.

We continue to offer telehealth when distance, childcare, or logistics make it the better option. But our heart lives in the room, where presence does what technology simply can’t.

If you’re considering therapy and want to explore whether we’re the right fit, we’d love to connect and talk more.