Holding Uncertainty: Making the Unknown Seen
Sophia Hilsen shares her story of an “invisible disability” and how her struggle has helped shape her work as a therapist.
When I think about what therapy means to me, it’s really about transparency, bringing light to the parts of our lives that feel too heavy or hidden. I once heard another therapist say, “My job isn’t to fix people; it’s to understand them.” That idea has stayed with me.
So much of my work is about creating safety. I pour my heart into developing trust in the relationship we have because that’s what allows the deeper work to happen. I’ve learned that safety often comes through the smallest gestures: tone of voice, pacing, presence. I tend to speak softly, especially when a client brings in chaotic energy, when it feels like emotions are spilling over after being bottled up for too long. I see that as the steam rising from a pot that’s been boiling for years. Once the steam settles, we can sit in the warmth together and really feel what’s there.
I didn’t always know I wanted to be a therapist. In undergrad, I wanted to help people, but I wasn’t sure what that meant. I worked in nonprofits and did community coalition work around teen substance abuse prevention. Eventually, I found myself working for the state, helping to pass bills related to substance use prevention, and while that work mattered deeply, I started to feel a growing gap between policy and people.
I wanted to be closer to the heartbeat of change, to work with people, not systems, so I became a “student assistance professional,” the person teens were sent to when they were caught with substances or showed signs of struggling at home. Those were my first clients: teenagers in crisis, carrying more than they knew how to name.
I felt like an imposter most days, but I also saw the huge gap between the mental health support teens needed and what was actually available, especially during a collective crisis. I was instructed to focus only on substance use, even when it was clear their deeper pain was driving it. That disconnect pushed me toward graduate school. I wanted to be the kind of practitioner who could sit with people in the heaviness, offering care that doesn’t silo, but makes space for all the intersecting parts of their lives.
The Layers of my Life
I work from a lens called Relational-Cultural Theory, which centers the belief that healing and growth happen through connection. I view people within all the systems that shape them: their inner world, relationships, culture, and the broader social contexts we’re all navigating. From this perspective, our struggles often stem from experiences of disconnection, whether from ourselves, others, or our communities. Healing to me is a relational process, one that restores a sense of belonging.
Anxiety, for example, has become almost universal. We’re living through a collective uncertainty, and there’s no tidy answer for that. Often my work is simply helping people find grounding and connection in the middle of it, to practice curiosity and compassion toward emotions like uncertainty rather than running from it.
Living with a neurological disorder
That practice isn’t just professional for me; it’s deeply personal. I live with a neurological disorder, which affects my nerves and causes chronic pain and muscle weakness. It’s considered an “invisible disability,” and for a long time I tried to minimize it, to push through. But living with a condition like this brings an ongoing relationship with grief and uncertainty.
You don’t get to finish processing it; you learn to live alongside it.
Over time, I’ve come to see that my work as a therapist and my life living with a disability are deeply connected. This disorder has taught me how to hold space for grief, the slow, evolving kind that doesn’t have clear answers. It’s taught me what it means to live in a body that doesn’t always cooperate, and how to extend compassion to myself on the days when pain or fatigue win. It’s also made me more attuned to others who live with invisible pain, physical or emotional.
Last month, I had the opportunity to speak at a conference about grief, shame, and uncertainty in living with neurological disorders. Preparing that talk was one of the hardest and most healing things I’ve ever done. Every time I practiced it, I cried. I wasn’t sure I’d be able to stand on stage and say those words out loud.
However, when I stepped into a space of acceptance for my own emotions and needs, allowing myself to share the vulnerable parts of my story, I felt an immense sense of peace and authenticity. I made a decision that day: I would care for myself through it. I brought a cup of tea and a tissue box on stage and gave myself permission to feel whatever came up. In that moment, accepting myself, my story, and my needs, I experienced a deep sense of freedom and wholeness. I realized I didn’t have to perform composure; I could model authenticity. And in doing that, I invited everyone in the room to do the same.
“Over time, I’ve come to see that my work as a therapist and my life living with a disability are deeply connected. This disorder has taught me how to hold space for grief, the slow, evolving kind that doesn’t have clear answers. ”
The Ocean and the Work
Whenever I need to reconnect, I go to the water. I’ve moved around a lot, but I’ve always needed to live near the ocean. It’s where I find calm, where the noise quiets down and I can just breathe. The waves remind me of the rhythm of healing, how it ebbs and flows, always moving but never rushed.
Living with a disability has taught me that healing isn’t about fixing what’s broken. It’s about finding peace in what is, in the uncertainty, in the grief, in the imperfection, in the constant movement of life.
That’s the same space I try to create for my clients: one where they can exhale, be seen, and remember that even when the waters get rough, they’re not alone in learning how to float.