It takes a certain mentality. You concede white a developmental advantage at a cost, a center pawn. You then need to counter-attack aggressively. If you hold your own, then black often comes out at least equal and highly active. But if you play passively, and don't take advantage of your tactical and positional resources...it won't end well.
From the white perspective, it feels like black is much more in the driver's seat than he is than in most french and ruy lopez lines. I remember my first game against a sveshnikov, it was a very disconcerting loss of control having no knowledge of the lines. It is much clearer (to me) in most french and ruy lopez lines what you should be doing as white.
Sicilian players love getting attacked. We kill your attacks!