Obsessive focus on the feelings and opinions of others (self consciousness) is at the root of many people's social anxiety.
Complete indifference makes you a pyschopath but there's such a thing as being too concerned about other people's feelings.
To open your mouth and speak to another person is to risk offending them. There are people who are so afraid of that possibility that they never speak. In that case, less empathy/more indifference is good.
That being said, I have an issue with this being called 'therapy'. It may as well be, if we just think about the person receiving the benefit. However, it's a bit predatory through the lense of the other person.
But it's like you said. It's not binary. Yes, it bothers me a little. Nonetheless, as with everything, it may have its uses.
Again, thanks for your comments.