Fellow Substacker , writing this past February, described standing in a stranger’s kitchen at three in the afternoon, holding a glass of tap water “like it was a moral alibi.” Nothing bad had happened. Everything had been consented to. And yet she drove home certain that something had gone quietly, unnamably wrong. Her essay ends on a line that stays with me: consent is not the same thing as being cared for.

Williams is diagnosing a specific and gendered cost. Drawing on Eva Illouz, she argues that casual sex doesn’t just reflect the shedding of repression —it reorganizes intimacy according to a market logic that prefers portable, self-managing, emotionally autonomous subjects, and that this logic falls disproportionately on women, who are trained from childhood to do the relational work that frictionless encounters ask everyone to suspend. When that training meets a script demanding detachment, the capacity for attunement doesn’t disappear. It turns inward. It becomes a private burden mistaken for a personal flaw. covers adjacent ground from a different angle — less concerned with market logic than with what happens, socially, to women who decline to supply what the male gaze expects of them.

I want to take her diagnosis somewhere she doesn’t go: into the therapy office where I work.

Because the same disciplined inhibition she describes — the same demand that care be suspended so an exchange can stay frictionless — shows up in psychotherapy too, dressed in different clothes. It’s a field that is roughly seventy percent women, and that isn’t an accident. It’s the same sorting that assigns relational labor to women generally — and turning that labor into a manualized protocol is simply what happens once it becomes billable. It doesn’t show up as sex, but as symptom management. Not as a hookup on an app, but as a treatment protocol.

A client arrives wanting relief, and increasingly, the field is organized to give it to them fast, cleanly, and without residue: a technique, a worksheet, a diagnostic code matched to an intervention matched to a billing cycle. No claims on time. No claims on history. No claims on the relationship itself, which is treated, at best, as a delivery mechanism for the actual treatment happening elsewhere in the algorithm.

This can look like progress. It can even feel like progress, the way that kitchen encounter must have felt, in the moment, like freedom. But there’s a difference between her situation and mine, and it’s no small one. Two people leaving a kitchen owe each other nothing in particular. A clinician and a client are not equals negotiating a frictionless exchange between consenting parties. One of us is licensed, trained, and paid specifically to provide a kind of care the other person cannot easily get elsewhere. If consent turns out to be insufficient even between equals — if Williams can do everything right by the rules of the encounter and still come home diminished — then what does it mean when the asymmetry is built into the relationship by design? A protocol like CBT or ACT can be entirely consented to, entirely evidence-based, entirely defensible in a chart note, and still leave a person having quietly misplaced themselves somewhere between the intake form and the discharge summary.

The unthought known doesn’t show up on a symptom checklist. It shows up slowly, in relationship, over time that no protocol is built to accommodate — because protocols, like dating apps, are optimized for throughput, not attachment. The client who wants to be known rather than managed is not being difficult. They’re identifying, correctly, that something essential has been quietly redefined as inefficiency.

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