That makes me wonder if in a lot of places around the world the effectiveness of care and therapy is severely handicapped by the inability to communicate / articulate these nuances -- on the part of both the patient and the therapist. (Here in India for example we pride ourselves on having so many languages. Oftentimes this causes real practical issues too. For example in metropolitan areas like Bangalore -- local residents face challenges like being unable to communicate with their bank teller due to lack of a common language between both. Non natives from elsewhere in the country are also inconvenienced if not discriminated, excluded and intimidated basis language. In such a chaotic environment having a deeply meaningful communication channel with your therapist sounds almost like an impossible ideal.)