I think a lot of it has to do with shame, maybe a fear of rejection and... I know for me at first... A lack of personal boundaries and/or trust in the ability of others to take care of themselves. I grew up being the parent and did not have good boundaries in that I'd want to fix others and I figured no one had their own boundaries enough to make sure they take care of their own selves. So, I'd avoid bugging my T at first because I saw her as potentially weak and incapable, then because of my own shame and desire not to be invasive (it's a cultural and also a deep guilt thing for me anyway) and now.., I protect her less knowing she takes care of herself. Yes means yes, no means no... Neither mean anything about me and I can trust her to handle herself personally and in my therapy. A very attractive thing to my sense of safety and trust.
So maybe I think it comes down to trust in the end? I don't trust people who can't actualize to a person separate from others and/or pain,.. I'm Lesrnjng bit I get triggered because I'm afraid of my own boundaries being violated., or me violating my own boundaries by letting myself get in relationships where the life is sucked out of me by need that I get lost in trying to attend to (sorta like codependency).
Sorry this may be confusing. It's hard to trust ourselves and our Ts and the relationship with them. Maybe fear of ourselves and any intensity or well, any range of things. I can empathize... It does prevent inviting our needs in to a relationship.