Consent as the Cornerstone of Practice

One of the most powerful medicines we offer requires no remedy vial, no protocol, and no

technical expertise. That medicine is consent.

When we hear the word, many of us think of the grade-school version of consent, or we groan at the idea of asking for permission for things that feel like reasonable expectations. In our field, consent is often thought of only in its most visible forms: permission to begin care, or assumed consent that comes following a client signing an intake form. But the practice of consent goes far deeper and is not just a one-time formality but an ongoing practice — even with clients we’ve seen for years!

Consent is woven into every therapeutic conversation, every session, and every choice we make as practitioners. It is the fertile soil in which a therapeutic relationship blossoms. With consent, we establish agency rather than authority, which helps to heal areas of our clients’ lives where autonomy has been stripped away. Without it, we risk unintentionally repeating the very dynamics of powerlessness that may have harmed them in the past.

Consent begins with clarity. It lives in the way we ask before entering difficult territory, or how we signal when the pace, tone, or direction of the session is going to shift:

• Would it be alright if we talk more about this?

• Before we move on, is it okay if we stay with this emotion/experience for a few

  moments longer?

• I notice some tension around this — would you be open to exploring it, or not today?

• We’re going to switch gears here so that I can ask about x, y, or z.

• If at any point you’d like to return to something we’ve previously talked about, please

  do.

• If we touch on something you’re not ready to discuss, just let me know.

The list goes on…

These small invitations are more than a practice in politeness. They are reminders that the

client’s voice matters and that they remain the author of their own story. Each question,

preparatory statement and educational insight, is a thread that weaves safety and trust into the fabric of the session.

Practicing consent keeps our minds open to the possibility that explanation or education is

needed from us before navigating towards something frightening, delicate or preciously held. Each client has their own path, their own pace, and their own vantage point from which they feel safe enough to share or make new meaningful connections and insights. Not everyone is ready to rush into the depths of their psyche, nor should they be pushed to prematurely take the leap from A to Z.

When we ask permission, we invite them to walk with us down that path. We may discover

familiar routes they’ve traveled before or even uncharted territory — places they have avoided out of fear or uncertainty. We are like guides carrying the fire of Prometheus, offering just enough light to illuminate the next step. The fire does not force them forward, but it reassures them that they do not walk into the unknown alone.

Consent creates boundaries. It affirms in both spoken and unspoken ways that the client is free to choose what they share, and free to stop whenever they need.

This is especially vital when working with trauma, grief, or deeply personal material as we so

often do. By making as much space for “no” as we do for “yes,” we prevent harm and avoid the subtle coercion that can occur when a practitioner pushes too far or asserts a maligned

conclusion or interpretation. Instead, the session becomes a container strong enough to hold what arises, while flexible enough to respect the client’s pace.

At times, we may gently reflecting back what we notice: a pause in speech, a sudden shift in

tone, a tightening of the body. When we say, “I sense some hesitation here — would you be open to sharing what’s coming up for you?” or “If you don’t mind sharing, what was the thought you had just before you chose to say something different?” we bring awareness to what might otherwise stay hidden.

Reflection paired with permission allows clients to meet themselves more deeply without ever feeling cornered so they can decide how they would most like to proceed. However, sometimes a client’s “no” is subtle and at other times it is explicit. Either way, this “no” tells us exactly what they are prepared to face and consent also means respecting that limit.

For students, the impulse to “rescue” is a natural response to associating that our inquiry has or will cause discomfort. At the sight of suffering, the instinct is to comfort, reassure, or offer solutions. But this very impulse overrides consent. By filling silence too quickly or providing solutions instead of inquiring as to what theirs’ may be, we take the process out of the client’s hands.

True consent means resisting the urge to rescue. It is about trusting the container, trusting the client, and trusting that discomfort itself has value. The tension, the silence, the not-knowing; these are not voids to be filled, but essential parts of the healing process.

When we hold our boundaries, invite instead of direct, and remain steady instead of rushing in, we respect both the client’s autonomy and the mystery of the work itself.

Reflect with me

How often do you assume consent rather than invite it? Do you allow silence to breathe, or do you rush to fill it? Do you offer genuine choices, or do you unconsciously guide the client toward where you think they should go?

The practice of consent is subtle, but it pervasive and transformative in practice. It communicates respect. It strengthens trust. And most importantly, it creates the very conditions in which healing can unfold. I feel, it is the heartbeat of our homeopathic partnership.

written by Frank Molignano, CCH, RSHom(NA), PHI Faculty