Have you ever been thirty minutes into a session with a client and found yourself completely overwhelmed? Maybe you’re asking yourself, how did we get here? Where did this thread start? It’s a stressful feeling, isn’t it?
You know that eventually they’re going to stop talking and then the spotlight is on you. You’re expected to keep all the facts straight and synthesize what they’ve said, validate and empathize with their story, and provide some sort of helpful and relevant opinion. It’s a lot. It’s overwhelming.
I’ve had this experience several times, especially with couples and families. Early on I saw a couple who didn’t only talk the whole time, they fought the whole time. Anger is an emotion I am working on being comfortable with to this day, so the added emotional tension made it even more difficult for me to keep my head straight and my emotions in check. I felt flustered and afterward felt a sense of inadequacy about it all. That kind of overwhelm can really take its toll.
I needed help
One of my supervisors is a sage when it comes to working with couples and families. He has his PhD in couples therapy, decades of experience in the field, and is steeped in a particular theory of couple therapy called Emotionally Focused Therapy. But he didn’t start that way.
After picking his brain as to how he handles overwhelming experiences, I got the idea that there wasn’t a silver bullet. He talked about specific techniques you can do in session (which we will talk about as well) but what it comes down to is experience and practice. Over the years he’s become someone that doesn’t need to reference the guide of poise for handling overwhelming situations, rather, he embodies it. It’s in his bones.
If you’re like me, though, I do not always embody poise. So, let’s start with a few techniques you can try in session when you’re feeling overwhelmed. Then we’ll talk about the practices you can do outside of session to get one step closer to embodying that poise.
In-Session Techniques
Note your feelings
Part of what is so distressing in these kinds of situations is the mounting anxiety we feel about the situation. As we become more anxious, we become fearful about how anxious we are feeling. Fear and anxiety tend to fog our thoughts because our brain is ringing the emergency bell saying that something is not right here.
One of the best things you can do for yourself, and subsequently your clients, is to note that you are feeling anxious and then provide a self-compassionate perspective:
Ah, there you are Anxiousness. I appreciate you trying to warn me, but I’m actually ok right now. I have been here before. I will make it through.
This is also valuable information for supervision. With your new awareness of your emotion, you can explore with your supervisor why this came up for you and how it might have affected the therapeutic relationship through countertransference.
If we are not aware of our feelings and fail to address them, they will only grow louder and louder like a child crying for help. So, check in with yourself and offer some compassionate reassurance.
Verbalize Your Feelings
While you can try to soothe your feelings when you are overwhelmed, know too that your feelings are not a liability to the therapeutic process. They can actually be quite helpful and informative. A supervisor of mine encouraged me to tell my clients when I am starting to feel overwhelmed by what they are saying. She said,
“They’re probably more overwhelmed than you, they’re the ones living it!”
Showing your empathy
Telling your client that you are beginning to feel overwhelmed is a sign of your empathy for them, that you are feeling what they are feeling too. You might say,
Wow, this is really overwhelming, isn’t it? I’m feeling overwhelmed myself, I cannot imagine what you must be feeling right now.
Valuable reflection
Verbalizing your feelings can also provide valuable information to your client about how they might be affecting others in their life by how they talk about themselves. It can provide insight into why they might struggle to be heard. You could say,
I have to admit that this is all quite overwhelming for me. I wonder if your partner feels the same way when you try to tell them how you feel? What do you think?
The therapeutic relationship is where we do much of the work. It would be stunting the process to not leverage your own feelings into a therapeutic moment. Rather than talking about why the way your client is communicating isn’t working, show them how it is affecting you, how it makes you feel. All of this is done within the safety of the therapeutic relationship which allows our clients to explore these tender moments and face their growth edges without the fear of judgement.
ethical considerations
To be clear, we never mention our feelings in a way that makes the client feel they need to attend to you. It always needs to be a purposeful intervention that is intended on helping the client access new insight or have a new beneficial experience. Notice that the previous examples all ended with the focus back on the client and their experience.
Your feelings are valuable to the therapeutic work. If you have trouble verbalizing your feelings to your client, you may also want to explore for yourself why that might be the case. Is it a professional boundary keeping you back from saying what you are feeling or are you afraid about something else?
Interrupt
If you’ve found yourself anxiously waiting for your client to finish their thought so that you do not come across as rude, welcome to the club. Some people have no problem interrupting others, but for those of us who do and fear ever doing so, we have some growing to do.
Rather than being rude, interrupting may be the most helpful thing for a client. Some clients talk because they feel awkward with silence and may need reassurance that silence is ok. Some have trouble knowing what they want to focus on so they will offer a wide variety of experiences and may benefit from you directing the flow of the conversation. And some clients, especially in couples therapy, can do a lot of damage if not interrupted and would benefit from you “catching the bullet” before it hits their partner.
Examples of how to interrupt
You can do a service to your client by gently nudging in,
Adam, just a moment. What you are saying is really important and I don’t want us to miss something here.
Or for those couples who you can tell are about to turn their anger into something hurtful,
Tamara, hold on. I know what you have to say is important, I’d hate for your partner to not hear what you are saying because of how you are saying it. Let’s slow down for a moment.
Sometimes clients talk in abundance because they don’t feel heard. Reassuring them that you do hear them and what they have to say is important to you is often quicker and more effective than them trying to convince you. Often that is what they felt they had to do in their own relationships or family of origin to be heard and seen. You can show them they don’t have to do that with you, that you are intent on hearing and seeing them.
For those of us who struggle to cut someone else while they are talking this is going to be a struggle. It has been for me. But I try to recall that I am not cutting in to be rude. On the contrary, I want my clients’ voices to be heard and I want to see them move closer to their goals. And if interrupting them from time to time is what is going to help them, then it is on me to get comfortable with my uneasiness and cut in.
Practices
Opening and stablizing your awareness
In Dr. Dan Seigel’s book Mindsight, he offers a framework for creating positive change through your mind. By focusing your attention on the mind through Openness, Observation, and Objectivity, he suggests you can integrate otherwise disintegrated, chaotic, and rigid states of mind into an integrated flow that is Flexible, Adaptive, Coherent, Energized, and Stable (FACES).
In other words, through the practice of focusing our awareness in a certain way, we can open and develop a sanctuary within us that is able to weather the stressors of being with our clients.
That “certain way” of focusing our attention is with the 3 O’s:
- Openness is curiosity and willingness to see and accept things as they are.
- Observation is the ability to stand back and see our roles in events and how we reacted without passing judgment – simply noting.
- Objectivity in this case is not in contrast with subjectivity, rather, it is the holding of our thoughts, feelings, and beliefs gently and with the knowledge that they come and go.
With this in mind, we can build a practice of paying attention to our own mind. Rather than being our thoughts and feelings, we begin to observe them from a distance and more thoughtfully and compassionately interact with them.
Over time this practice seeps into our bones and becomes more of a trait – an openness to what may come and a calmness and curiosity about it. We observe repeatedly that our thoughts and feelings come and go, and we begin to have more faith in our own stability.
Next time we begin to feel anxious, rather than fear being our initial reaction, we might say to ourselves,
Ah there you are again Anxiety. What is it you are trying to tell me? Thank you for that, I am ok right now. You may go.
I suggest watching the video below as a guide to a breathing exercise.
developing a pre-client ritual
A cluttered mind before a client will directly translate into an even more cluttered mind during your session. Having time at the beginning of your day and in between clients to prepare and shake off any “psychological contaminates”. in the words of Dr. Robert Wicks is key.
Here is a list of practices and ideas you might consider for your own pre-client ritual:
before your first client
- Look at your caseload the day before
- Listen to relaxing music on the way to work
- Have an object with a calming and positive association nearby (painting, bracelet, favorite mug)
- Make yourself a cup of tea or coffee (careful with caffeine though!)
- Write down why you find this work meaningful, keep the note nearby
- Review your entire caseload and last session’s notes
- Jot down a few potential avenues to explore
- Do a mindful breathing exercise
- Extend compassionate thoughts and feelings toward your client before they arrive
Between clients
- Take a deep breath immediately after
- Note your feelings
- Extend compassion toward yourself and your client
- Stand and stretch
- Have a glass of water
Try out a few of these and think of your own that would help you get in the right mindset to be present to and attuned with your clients.
Wrapping Up
We all get overwhelmed at some point with a client. It’s inevitable and it’s okay if you find yourself there too. AND we can practice and prepare to help set us up better for next time.
So, here’s my challenge for you: pick one of the above, whether it’s an in-session technique or a practice you want to start and take 5 minutes thinking about how you can begin utilizing it today.
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