Well, at least she had some kleenex and she offered them. I once had an initial consult with a therapist, started to cry, which is inevitable in my little world, didn't see any kleenex in her office, started to look in my bag, couldn't find any and so I finally asked her for some kleenex. She was totally flabbergasted, as if I was the first of her patients to start crying. She simply said that she didn't keep any in her office (for whatever reason, some weird psychodynamic preconception or maybe even stinginess). So I went for some toilet roll because I was really crying.

Why is the fact, that the kleenex box stands behind the curtain, an indicator for you that the therapist is uncaring? She offered the kleenex, you didn't even have to ask. There's plenty of therapists out there who won't offer kleenex. In their world, you will have to "take responsibility" for your tears and ask for tissues. Or they don't want to force kleenex on you in case you don't feel comfortable with your own tears etc. There's a thread out there somewher about therapists and their tissues/kleenex, maybe it might be interesting for you to read a bit there so you get an idea, that with therapists and kleenex, anything is possible?

There could be 1001 reasons why the box was behind the curtain. Maybe she doesn't even keep them there, but an overzealous cleaner puts them there to keep them away from the surfaces. Maybe the box behind the curtain is "extra", and the normal box was just emptied by the client before you? Maybe the client before you has a kleenex phobia and she as a therapist is considerate enough to keep the box out of sight?

Why don't you ask her why she keeps the box there? Instead you jump to conclusions that seem rather strange to me. I just don't get the correlation at all that you open up between the place of the tissue box and the coldness and distance of the therapist.

I find my therapist overall rather warm and caring. But whenever I cry I need to start looking for the box, since it might be anywhere: On the couch, under the couch, next to one of the armchairs, on the windowsill. So yes, 9 out of 10 I need to get up and get those tissues by myself. And yet it never occured to me to think of my therapist of any less caring. So why do you place so much importance on a rather neglegible detail?

Sarah, to be honest, to me it seems that anything else but a disappointment would have been disappointing to you.