# How Therapists Regain Presence After Emotionally Difficult Sessions - Published: 2026-10-28 - Author: [Psychologist Brief](https://psychologistbrief.com/author/psychologistbrief-com.md) - Topics: [Q&A](https://psychologistbrief.com/qa.md) - Source: https://psychologistbrief.com/qa/how-therapists-regain-presence-after-emotionally-difficult-sessions/ - Publisher: Psychologist Brief ### Reserve Time for Grounding Having the right system in place to handle these moments has saved me from having some potentially poor sessions. The reason that I am saying system is because that I what I believe can do the best job of handling these moments in session. For me, and what I teach other clinicians to do is to make sure you are trying your best to wind down session with enough time to sit with any lingering material from the activating session. When you carve out that time, processing and action gets infinitely easier. At minimum, leave yourself a good 5-7 minutes. If there is another client waiting in the lobby, gently let them know you have some things to quickly take care of prior to session, and that you will grab them in a moment. Take your full regulation time, the client waiting will be fine. Once you have your 5 or so minutes, start by grounding yourself, and regulating your body as best you can. Check your breathing, check your body tension, and do your best to lower them both to a reasonable level. From there, if you need to write the moment down for later, that way you are honoring the feeling, please feel empowered to do so - that way we're not obsessing over it during the next session, it's there waiting for you. Finally, we have to always remind ourselves that we're human, and these moments are going to happen occasionally, and much like we tell our clients, we also need to remind ourselves of what actually got activated in session. Taking a quick moment to check that out may help you engage back with your prefrontal cortex, and may be enough to bring you back to regulated prior to the next client. It will happen fast, and sometimes these steps I just outlined happen in seconds. Be easy on yourself, breathe, engage with your top-down thinking, breathe again, and then transition into the next client. --- ### Use Self-Checks and Consultation Clinicians are people, and some sessions land hard. I don't think the goal is to feel nothing. The goal is to notice what I'm feeling so it doesn't quietly steer the next hour. Between appointments, I keep my reset simple. I stand up, take a few slow breaths with a longer exhale, and name what is going on in plain words, something like "that was heavy, and I'm still carrying it." Naming it takes some of the charge out. Then I drink some water, step away from the screen for a minute, and write down anything I need to come back to, so I'm not trying to hold it in my head. When I walk into the next session, I try to arrive curious about the person in front of me instead of still replaying the last one. The one practice that has helped me most in keeping my reactions out of the relationship is regular self-check-ins, backed by consultation and supervision. If I notice I'm feeling unusually frustrated, protective, or worried about a particular client, I treat that as information to bring to a trusted colleague, not something to act on in the room. Talking it through with someone else keeps my own reactions from becoming the client's burden. I also try to stay honest with myself about my limits. If I'm running on empty, I build in a longer break, because being present matters more than being busy. Steadiness is a skill, and it works better as a habit than as a fix after a hard day. --- ### Ask Whose Feelings You Carry In speech therapy, I often sit with people during some of the hardest moments of their lives: a stroke survivor who cannot say a family member's name, or a spouse learning that a swallowing problem may not fully resolve. Those sessions stay with me, so I treat the time between clients as part of the work. My reset is physical. I step out of the room, take a few slow breaths with a longer exhale, drink water, and walk briefly. Then I jot one line in my notes about what I felt, separate from what the client needs. Naming it keeps it from spilling over. The one practice that has helped most is a short check-in before I open the door: "What am I carrying right now, and is it mine or theirs?" If it is mine, I set it down for the hour. If it is theirs, I let it guide my compassion, not my pace or advice. Talking through hard cases with a colleague also keeps my reactions from quietly steering a client's goals. Steadiness is not the absence of feeling. It is noticing it, naming it, and staying with the person in front of you. --- ### Resist Urgency Before You Respond An emotionally intense conversation can leave a lingering urge to reassure, challenge or resolve something immediately. I would pay particular attention to that urgency because it may subtly influence how subsequent information is interpreted. A brief transition of 2 or 3 minutes might help someone acknowledge the emotional response, although stronger reactions could warrant additional time or professional consultation. In my judgment, genuine steadiness means recovering the ability to listen patiently and make independent judgments even while some emotion remains. --- ### Practice Radical Acceptance As a mental health therapist working full time in private practice for the past 5 years, I have certainly had plenty of sessions that have left me emotionally activated. I recognize the importance of regulating myself before joining my next client, and have developed a variety of skills over the years that assist me in regulating myself. My go-to's often include diaphragmatic breathing, grounding through movement (there are often days where I spend a few minutes between sessions practicing yoga poses!), and practicing radical acceptance. Focusing on radically accepting a session as is allows me to foster compassion, understanding and a non judgemental space for both myself and my clients, despite the challenges that may come up. Through this ongoing practice, I have found that I am able to offer a neutral and open response to clients rather than experiencing a reaction that is based in personal judgement, experience or perspective. --- ### Continue Your Personal Analysis Psychoanalytic training prepares you to be less activated in general. Years of personal analysis, learning to sit with and metabolize the wide range of human emotional material, guts on the table, is the preparation that reduces activation and makes activation workable. If an activating issue gets my attention after a session, that becomes a prompt for me to explore and analyze the activating issue. It helps me to question myself: Why is it 'activating' me and what am I missing here? When I understand my own activation and understand the issue at hand, I can position myself to be curious in a way that alleviates the activation -- in myself and in the session. Years of personal analysis built the capacity to recognize what's mine and not the client's. What I'd say to any clinician asking how to relieve emotional activation: To reduce activation, you simply need to continue your own ongoing analytic work. You cannot metabolize what you haven't examined in yourself. And what hasn't been examined doesn't disappear. It shows up in the room, shaping what you notice, what you avoid, and what you reach for when the session gets uncomfortable. Personal analysis is the foundation of psychoanalytic training and it changes everything. --- ### Name Reactions With Colleagues I don't try to get the reaction out of my system before the next session, I try to find it. In the few minutes between clients I'll ask myself "Whose feeling is that?" It may be a reaction to what the client has brought in and that's clinical information. It may be mine, a reaction to something from my own life and that's something that belongs in supervision rather than in the next session. I write one line in a private note stating the reaction and the moment it occurred. I then do a physical reset (feet flat on the floor, a few slow exhalations with a longer out than in, and a deliberate look at the next client's chart to ensure my attention is somewhere specific). The practice that has protected my therapeutic relationships the most is to bring those notes to regular consultation with colleagues. If I've named that reaction out loud to another clinician it's far less likely to then influence my next intervention without me realizing. As a Clinical Director I also treat it as a team issue rather than a personal one. Clinicians need protected time between sessions to do this, not back to back scheduling which leaves absolutely no time for it. --- ### Examine Reactions Before Intervention When a session leaves a clinician emotionally activated, I recommend assessing readiness rather than trying to erase the feeling. The practical question is whether you can listen openly and make sound clinical decisions without rushing, becoming overly directive, or carrying assumptions from the previous session. Take a brief pause away from clinical material and orient to concrete facts: where you are, what time it is, and what task comes next. Then notice whether your attention keeps returning to the prior session. If it does, identify what needs later reflection, consultation, or supervision and redirect your attention to the present. If concentration or judgment remains affected, follow established consultation or coverage procedures. Steadiness means having enough choice not to act automatically from the emotion; it does not require feeling nothing. One practice I recommend is treating a strong reaction as something to examine rather than as a conclusion about the client. Within confidentiality requirements and established procedures, consider what personal expectation, relational pattern, or feature of the interaction may be contributing to the response. Before changing an intervention because of that reaction, consider at least one alternative explanation and, when appropriate, discuss the pattern in supervision or consultation. This can reduce the chance that protectiveness, frustration, or urgency determines the pace or direction of treatment. A reaction may contain useful clinical information, but its value comes from examining it rather than acting on it automatically. --- ### Orient Yourself to the Present As therapists, we're not immune to being emotionally activated in the therapy room. Our capacity to be moved by another person's experience makes therapeutic connection possible. What matters is recognizing our responses without allowing them to direct the work. When a session leaves me activated, I notice what's happening in my body. Am I holding tension? Has my breathing changed? Do I feel an urge to move or withdraw? Before analyzing my response, I give myself a moment to notice it without judgment. One practice I find useful is orienting. Between sessions, I look around my office, notice the light through a window, feel my feet on the floor, or settle my attention on something pleasant. This helps me reconnect with the present moment and recognize that the previous encounter has ended. I also notice incomplete impulses. Sometimes that means standing, stretching, or walking briefly. I don't need to eliminate every trace of emotion before seeing my next client. I need enough capacity to be present without my activation taking up the space. Ongoing awareness of countertransference is essential. When a client's experience evokes something personal, I want to recognize that response as information rather than unconsciously act from it. Sometimes I bring it to clinical consultation or my own therapy. I think about this as the difference between joining and merging. Joining allows us to connect empathically with a client's experience while remaining aware of our own internal state. Merging happens when we lose that differentiation and experience their emotions as our own. Somatic awareness helps me recognize that shift and restore differentiation without withdrawing from the relationship. Good therapists aren't always regulated. We're human beings in relationship with other human beings. What matters is noticing when we've been affected, taking responsibility for our responses, and returning to curiosity and presence. Our clients deserve to have their experiences met without having to manage ours. ## Related - [How Psychotherapists Reset After Emotionally Demanding Sessions](https://psychologistbrief.com/qa/how-psychotherapists-reset-after-emotionally-demanding-sessions.md) - [Repair Ruptures in Psychotherapy Without Getting Defensive](https://psychologistbrief.com/qa/repair-ruptures-in-psychotherapy-without-getting-defensive.md) - [Psychologists Share Practices That Protect Against Clinical Burnout](https://psychologistbrief.com/qa/psychologists-share-practices-that-protect-against-clinical-burnout.md) - [How Psychologists Help Clients End Therapy With Confidence](https://psychologistbrief.com/qa/how-psychologists-help-clients-end-therapy-with-confidence.md)