lol, I wondered if this was created by a fellow r/psychotherapy lurker.

My answer is I want to be offered tissues. I understand that some people feel like being offered tissues conveys disapproval and makes them feel silenced. I personally feel disapproved of and silenced when I am not handed tissues. So I guess I think therapists should just put their dilemma out there and ask each client their preference.

I definitely don't appreciate that the predominant view of therapists seems to be that offering a tissue is bad.