• The Tension in Therapy: When Personal Emotions Arise in Session

    A blue and yellow watercolor abstract painting.

    Let me set the stage: it’s January 2022. It’s dark and cold outside. I’m tired, inching toward the end of a full week of sitting with clients. I’m helping them navigate crises, and coming to terms with Omicron’s impact—an average week for those of us doing this work during a global pandemic. And still, to my surprise at the time, it happened. I was sitting in session with a client when a sudden wave of emotion, lurking just beneath the surface, began to wash over me. I felt it rise up suddenly in my chest, turning into a lump in my throat.

    I swallowed deep and returned to the present moment with my client. I’m a newer therapist, still learning the ropes, but I’m not alone in this experience—right? The one where, suddenly, you just feel sad and have to swallow your tears, all while in the middle of active therapeutic work?

    Emotions Beyond Countertransference 

    Technically speaking, I know what this is called: countertransference. I can reflect back on this moment and see my client’s tears, an outpouring of stored up sadness. I was, as we always are, a space of empathy, safety, and comfort for their emotions that had otherwise been trapped. It seems reasonable—natural, even—that a moment like this might elicit an emotional reaction from the therapist. After all, we do care deeply about our clients. And yet, this sadness didn’t feel like it belonged to countertransference alone. It felt deeply personal. It felt like the sadness was mine. I was just sad, and the heaviness of that week had caught up to me. 

    I’ve felt particularly tender toward these moments and the tension of this space we occupy, faithfully and willfully, day after day. A space where the burdens we bear in life outside of the therapy room are stirred up as we intersect with, and hold, the experiences and pain of our clients.

    I imagine that these moments really aren’t all that unexpected. The reality of our work can be a hard and lonely one, especially in private practice. We sit with client after client in some of their darkest moments, listen attentively to emotionally provoking stories, and are privy to a person’s deep sadness. This is part of the job—and the joy—of what we get to do. All the while, as therapists, we also bring to the room our own pain: feelings of disappointment regarding political divides, exhaustion from engaging in ongoing virtual therapy, and the anxieties in the world and our families. Life can feel heavy, painful, and full of sadness. So, of course there are moments in which our personal emotion is stirred as we work to gracefully hold the pain of our clients. 

    This is the tension of our work. And here, I feel an urgent question: What do we do with that?

    How to Process Personal Emotions as a Provider

    Since we’re attuned and well-trained therapists, we know how to address our emotions in the moment. We identify what’s happening to us, extend a brief kindness toward the feeling, and gently set it aside in order to remain present and engaged with our client—a process that sometimes happens before we are even aware it’s happening. 

    But, what about later? What do I do with those emotions when I’m no longer sitting in front of that client? This is the challenging part. We work alone. We might have 10 minutes before the next appointment. And, by the time the day is done and we’re locking up an empty office or shutting down a computer, that fleeting moment of emotion has either morphed into a thing of the past or become a burden that we feel forced to bear by ourselves.

    This is the reality of what we hold in private practice: it’s heavy, and we’re alone. In spite of this, though, I’ve found comfort and value in a few simple reminders that might prove helpful to us in this space.

    Honor your own humanity

    We have to remember that we’re just human beings, vulnerable to experiences of pain and sadness. We consistently bring into the therapy room our most human self and the emotions that come with that—good, bad, and indifferent. And that’s okay! In fact, it’s good. This is part of what enables us access to the empathy our work is based upon. We’re humans before we’re therapists, and the work we do doesn’t negate our personal lives. There’s a tenderness and compassion we can show our humanity in the moments our emotions are stirred. 

    Don’t avoid your own emotions

    Practice placing a mental, or physical, bookmark at the moment in time emotion wells up in you. It’s easy to move on quickly from one appointment to the next. I have 10 minutes before the next client arrives to inhale a glass of water, jot down a note, and review the next client’s file. A bookmark holds us accountable in going back to offer ourselves an opportunity to address the emotion. We know that unaddressed emotions lie dormant, as though in an incubator, just waiting to be released. These emotions are real, they’re yours, and they ought to be given space and empathy in the same way we offer this space to our clients.

    Find support in your personal life

    Identify your people who you can invite to come alongside you and help carry some of your everyday burdens. We don’t have to divulge client stories and or other confidential information in order to be cared for by the people we love and trust in our personal life. Find friends who can help shoulder the weight you carry. The work of therapy in private practice is an independent job, and having people in your corner who are places of empathy and support is like a drink of fresh water in a desert. 

    Find support from other clinicians

    Being part of a peer support group, or receiving supervision, can help mitigate the isolation of private practice. Therapy is a unique field, hindering us from being able to share candidly about our work with family and friends. Because of this, there’s an immeasurable benefit to brushing shoulders with colleagues who walk alongside you on a parallel path, and hearing them say, “I get it, I see you, and keep going.”

    Life is painful—we know that all too well. We have limits, we have emotions, and the work that we do is hard. It’s okay to feel sad. And, when that sadness wells up in you as you’re working with a client, take comfort in knowing that it will be waiting for you when you’re ready. 

    Let’s remember to be gentle and compassionate toward ourselves. We hold a unique tension in this work, juggling family, a global pandemic, administrative work, and the stories and experiences of every person who walks into our office. We graciously and faithfully provide space for our clients, and it’s important we do the same for ourselves.

    I share in the tension and absolute honor of doing this work we love. And, well, maybe this is nothing more than an opportunity for me to say: I get it, I see you, and keep going.

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