Sometimes clients think that therapists don’t have feelings. People imagine that therapists listen with detachment and forget about their clients as soon as they leave the office. Often, people wonder how I can do my job without becoming overwhelmed and flooded by people’s pain and stories.

The truth is that one of my mentors taught me early on that it’s very important for a therapist not to try to avoid having feelings in their work or to shut their feelings off. This just creates defensiveness and makes it difficult to use the feelings that come up in therapy to help our clients, as well as to tolerate those feelings ourselves.

One of the things I’ve learned is that I have feelings in my sessions, and sometimes they’re more intense than at other times. I’ve learned to be in a mode where I’m thinking about the feelings that are coming up. I’m thinking about my own feelings and the client’s feelings at the same time. There’s thinking going on while I’m also experiencing emotions, and sometimes those emotions are intense and difficult to contain.

I might feel very helpless with a given client. I might feel like I want to take care of them or mother them. I might feel very sad about their story or angry at someone in their life who seems to be mistreating them.

But it is one of the skills you develop after sitting with people for a long time: knowing how to hold the feelings that come up inside you during a therapy session without letting them inhibit your ability to think. It’s not that your feelings never take you over, and it’s not that you learn how to detach from them. It’s that you learn how to work with them: how to think about them, process them, and try to understand where they’re coming from; what they’re saying about you, about the client, and about the people in the client’s life.

That thinking activity, taking place at the same time as we’re experiencing emotions, is one of what I think are the hallmarks of psychotherapy. It’s the ability to connect the right brain and the left brain, to make narratives out of our emotions, and out of our visceral and intuitive experiences. It’s about putting things into words, creating stories out of our experiences, and developing a narrative around them that makes sense.

We don’t always know whether the narrative we construct is true, and therapy isn’t necessarily about finding the truth. We try to create an understanding that fits, that feels right, and that makes sense. There’s something healing about that.

Sometimes clients wonder whether I care. I do care, but there’s something about being in the therapist’s chair that makes people think you don’t. I’m not quite sure what it is. Maybe it’s the boundaries of the session. Maybe it’s the fact that therapists end sessions after a certain amount of time or get paid to listen.

Many therapists have also been on the other side of the couch. We know what it feels like. We have empathy for the client’s vulnerability, and we’re in the profession because we care. We want to help, but that doesn’t mean a client can take in that caring.

Some clients don’t want to believe we care. They don’t want to see us as human, too. They want to see us as detached and above feelings, as someone larger than life. Other clients don’t want to believe we care because they still have to work through the images in their minds of people in their lives who were uncaring. The negative has to be explored and let go of before the positive can be let in.

Just because we try to be nice doesn’t mean a client is ready to take that niceness in. This is hard for therapists. Most of us who care and want to help our clients feel better want to offer them something kind, compassionate, and good. Yet some clients don’t have the capacity to contain that, to receive it without becoming overwhelmed or without their negative projections getting in the way.

Learning how to tolerate wherever the client is, whatever feelings are coming up for them, and how to titrate what we say and what we let them know about what we’re feeling inside is part of the work.

I do think about my clients between sessions. I think about them a lot, too, but that doesn’t mean my whole life is consumed by the feelings that come up in a given session. I know there’s a process. I know that sometimes the pain can’t be finessed, even though I wish I could make it easier. I know that things take time and that the emotions or experiences of a given session can change within hours or even minutes. So I’ve learned to wait until the next session and see what comes up next for the client and for me. This is how I’ve found it best to stay well in my sessions, even though, for some clients, it’s hard to understand.

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