Viewpoint: Scents and sensibility
Therapy Today, May 2026.

I’ll begin with a caveat. As the years roll by I find myself increasingly identifying with the stereotypical slide into curmudgeondom. The therapist in me might frame this more generously as being simply more comfortable in my opinions. Hopefully the following will resonate with someone.

Reed diffusers. Scented candles. Aromatherapy oils. Pot-pourri. Plug-in air fresheners. I don’t think we practitioners give enough thought to the impact of scent in the therapy room. 

I have often, with a roll of my eyes, had to move multiple perfumed items in a (rented) therapy room before starting a day’s work. As an asthmatic, if I leave them where they are, all my spluttering causes clients to assume I’m either contagious or allergic to emotions. I’m no different when attending a yoga or meditation class. Smoky incense, so often intended to soothe, can quickly turn what should be a therapeutic pause into my own dramatic exit from the room, punctuated by explosive sneezes. 

Volatile organic compounds potentially released by reed diffusers can be problematic for asthmatics, causing wheezing, coughing or shortness of breath.¹ Imagine coming into a fragranced therapy room knowing you have asthma. You already feel vulnerable and nervous, and within minutes you’re struggling to breathe normally while trying not to look ‘difficult’. You’re not in a café, which you can simply leave; nor in a shop, where you can ask staff to turn something off. You’re in a therapy room, where the unspoken contract is that you’re the one being observed. There’s a power dynamic. 

In this situation a client might begin to question themselves: ‘Am I being dramatic? I don’t want to be that person.’ Therapists should be conscious of accessibility, and for asthmatic clients the irony around our profession inadvertently introducing an element that dysregulates us is hard to miss.  

Of course I’m biased. I once took a photo of a reed diffuser in a pub, ready to document how far this mania has spread — until a friend told me it was an empty pint glass with straws in it. The point is I was ready to leave that pub immediately, but the therapy room is a whole other arena. 

Sensory stressor 

The issue with fragrance isn’t only about health, personal comfort or whether someone likes vanilla over sandalwood. It’s about sensory realities that affect clients differently – and sometimes deeply. 

Neurodiversity and sensory differences are now widely recognised as complex and variable experiences. For example, guidance from the National Autistic Society highlights how many autistic people have mixed sensitivity across the senses, and even within the same sense, and that this can vary over time or by environment.² The therapy room is, I’d argue, exactly this kind of new environment for many people – and it can evoke strong physical and emotional responses before a word has even been spoken. 

As a practitioner my own responses to scent have made me question how I’m showing up to sessions. I joke about my strong physical reactions to fragrance but I’ve not fully recognised how easily it can leave me either befuddled or irritated – and less able to be fully present with a client. If I’m being generous, there’s a positive side: it allows me to show up as human. I’ll sometimes say: ‘Don’t worry, I don’t have a cold – it’s the fragrance in here,’ which sometimes conveniently acts as an icebreaker.

For a long time I assumed I couldn’t be alone in this. I’m not. Many people experience heightened sensitivity to sensory stimuli, including scent – and in the therapy room that can have real consequences for how safe, settled and present a client feels.³ In particular, neurodivergent clients can experience strong fragrances as olfactory distress, which in turn increases their anxiety and emotional dysregulation.⁴ In the worst-case scenario, a fragrance could remind them of past trauma. 

Memory triggers 

Scent is paramount in memory. Think of the first perfume you had as a teenager. Smell it and suddenly you’re back at school in the heady rush of adolescence. We have no idea what our clients’ scent maps are. For example, I was recently sitting in a waiting room when a woman took a seat across from me. Out of nowhere I became quite melancholic. I couldn’t establish why, until several seconds later I realised it was her perfume brand. I then felt a rush of emotions so complex that I genuinely turned to a stranger next to me and said: ‘Can you smell… church?’ In placing the scent, it was exactly that of a Catholic church – smoky, deep, evocative. I have good memories of going to church with my Irish grandmother, but the melancholy was a side dish served to me subconsciously. 

Studies show that olfactory inputs entirely bypass cortical functions and engage the nervous system directly, operating beyond conscious awareness.⁵ Emotional and physiological responses are therefore involuntary. I commend the woman in the waiting room for her bold, stylistic choice – I confess to an extended hunt for ‘perfume that smells like church’ – but this raises an issue: the relational complication. 

If scent can conjure church in an instant, it can just as easily conjure school, hospitals, funerals, a parent’s perfume, a partner’s aftershave. Your favourite scent store is not rushing to stock Eau d’Hôpital, I do understand this. However, in reality, scent of any kind can quietly shape the emotional tone of a session long before any clinical work begins. Scent is transference without words. It’s the room doing the remembering for the client. It’s one thing choosing the colour of a cushion for a therapeutic space; it’s another to introduce a stimulus that might evoke loss, painful trauma or shame. 

Why do it? 

I’m bewildered by how often therapists seem to operate from a position of autopilot when it comes to making a therapy room look nice, with little or no realisation that these are not solely our spaces. From the moment the client walks in it becomes the client’s space too. Does it really require a sandalwood reed diffuser? 

For all my protests though, I do understand why it happens. As therapists we want to make a room welcoming. We’re trying to communicate a sense of comfort to counteract the clinical chill of older models of therapy. 

Perhaps this is a wider sign of the commodification of therapy by the wellness industry. In a world where the overlap between therapy and wellness is blurred by big business, and our client is the consumer, do we run the risk of confusing ‘comfortable’ with ‘curated’? Therapy is expensive. People want to feel it’s worth it. Perhaps a pleasant room says: ‘Your money is being taken seriously.’ However, the aesthetics of a room can become performative care (‘look, I have considered your comfort, while ignoring the fact that your comfort is based on my assumptions’). The therapy room isn’t a wellness studio – it requires a degree of neutrality. 

Cultural sensitivity 

This brings to mind issues of cultural appropriation. I notice that the therapy space has increasingly borrowed from the generic global spirituality aesthetic – incense, Tibetan bowls, Buddha statues – often with little understanding of the cultures these objects come from. It becomes a kind of set dressing – shorthand for calm and groundedness. But what feels soothing to one person might feel performative or even offensive to another. Smell isn’t neutral. In my example of the scent that reminded me of church, it carried weight and informed my emotional response. It could have been an uncomfortable trigger for me. An incense burner next to a Buddha statue might feel like a harmless nod to mindfulness but it may land very differently for a Buddhist client. Fragrance-free neutrality therefore is an underrated ethical choice. It reduces imposing meaning. 

Crucially, we can’t rely on clients to tell us when something isn’t working. Unlike most consumer settings, a client will rarely say anything about the environment. Due to the power imbalance they will endure it. I experienced this myself with a former supervisor who regularly sprayed air freshener between each session. It so clawed at my eyes and got to my chest that I stopped attending. In theory those power dynamics in a supervisor/therapist relationship ought to be easier to navigate than in the client/therapist one. Yet here we are. This is probably why, when I hire a space and move 95 reed diffusers to a small corner of a room the size of a prison cell, I lean into breaking any façade of therapist with a self-deprecating reassurance that my fragrance-triggered sniffles are not a contagious flu. An attempt perhaps to not only diffuse (ahem) any power imbalance but also to indicate that I have thought about the environment and invite the client to comment on it. 

Solutions 

I’m not anti-comfort – I’m anti-assumption. Therapy rooms should feel warm and inviting. Neutrality, I argue, should be a default. Eliminating fragrance not only reduces the chance of triggering asthma – it also avoids the risk of triggering an unexpected memory for a client. It increases safety. The basics tend to do the heavy lifting – light, temperature, clutter. If the air is stale, open a window between clients. If the room holds odour, an air purifier could be a neutral alternative to fragrance. Make it easy for clients to advocate for themselves. Creating a space or demeanour that encourages explicit permission to speak out reduces shame and levels the power dynamic. 

I urge us all to consider how clients feel about fragrance use. Neutrality leaves space for the work rather than filling the air with our preferences. 

Ultimately scent isn’t a trivial detail. It communicates something about who the space belongs to, whose comfort is prioritised and what is assumed to be normal. The irony is that therapists are trained to listen for what isn’t said – and yet fragrance is one of those things we rarely truly discuss. If therapy is meant to be a place where people are invited to exist as they are, then perhaps the room should allow the same. Not curated. Not scented. Just safe enough to breathe in.