Question: I’ve found myself worrying about navigating difficult emotions and situations that arise during therapy sessions. I feel particularly unsure of how to handle situations when faced with clients who have complex and challenging issues, such as those dealing with traumatic experiences or intense emotions.
In these situations, I worry that my emotions and reactions may hinder my ability to provide effective therapy. I fear that I may become overwhelmed or triggered by the intensity of the emotions the client expresses, which could make it difficult for me to remain objective and provide the support that the client needs.
How can I manage my emotions and reactions better when working with clients dealing with traumatic experiences or intense emotions? What strategies can I use to help myself remain calm and focused while providing the support my clients need?
Response from Dr. Chua: It’s worth reflecting whether this is a realistic concern or whether this worry is just a worry. In other words, have you been overwhelmed by the intensity of the emotions, or are you worried that you will?
Harry Stack Sullivan described the role of the therapist as the participant observer: “His principal instrument of observation is his self- his personality, him as a person.” And the person is always subjective, influenced by their own experiences, traits, feeling etc. You will therefore never be truly objective, and believing you can be objective will stop you from realizing your own inferences and subjectivity.
Carl Rogers emphasized that being empathic is to perceive the internal frame of reference of another with accuracy… ‘with the emotional components and meanings…as if one were the person, but without ever losing the “as if” condition. This means to sense the hurt or the pleasure of another as he senses it and to perceive the causes thereof as he perceives them, but without ever losing the recognition that it is as if I were hurt or pleased and so forth. If this “as if” quality is lost, then the state is one of identification.’ (A Way of Being, 1980)
If you have lost the as if quality, you are no longer in a state of empathy but in a state of identification. You are now adopting your client’s feelings and being as if it were actually you who were traumatized in this narrative.
Certainly, if you are impacted by your client’s experiences and expression to the point that you are unable to provide support, you need some extra support yourself – which is why supervision and personal therapy will be good ways for you to work through how and why your client’s expressions are impacting you. It’s excellent that you realize this process is happening in session. I highly recommend facing it straight on by getting extra supervision and therapy so you can work through this.
You might also have shared very similar experiences with your client and are no longer able to maintain the as if quality as you are too activated. And if you find that, despite supervision and therapy, you are unable to maintain a working distance with your client, it’s appropriate to refer your client to someone else so that you can take time to work through your experiences and reactions. This is part of self-care and client-care.
There is no shame in being human. Acknowledge and accept your reactions, strengths and limitations, and continue to grow.
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