WELLGROUNDED WEDNESDAY: Staying Steady in the Storm: How Clinicians Can Maintain Internal Balance When Clients Bring Intense Emotion

As therapists, we sit with emotions that most people run from. Rage. Terror. Grief. Shame. These emotional states can fill a room before a single word is spoken, and part of our work is the courage to stay present instead of flinching. But even the most seasoned clinician can feel internally rattled when sessions become emotionally charged. It is normal. It is human. It is also something we can skillfully navigate.

This week’s Wellgrounded Wednesday explores what it truly means to maintain internal balance when clients bring intense emotion into the therapeutic space. Not by shutting down or emotionally distancing, but by cultivating steadiness, groundedness, and conscious presence so that our responses remain attuned and healing.

Why Intense Emotion Impacts Us

Even with training, therapists are not immune to emotional contagion. Neuroscience has shown that our nervous systems are wired for co-regulation. This is why a crying infant can cause another baby across the room to cry. As adults, we are more regulated, but the same wiring exists.

When a client expresses:

• Explosive anger

• Panic-level anxiety

• Deep despair

• Dissociation or emotional numbing

• Intense trauma recall

…our mirror neurons, vagal responses, and stress circuits activate. We may feel tightened muscles, increased heart rate, or emotional pull. This does not mean we are doing something wrong. It means we are empathic mammals.

The goal is not to “stop reacting.” The goal is to notice, to stay steady, and to remain the wise, grounded presence the client needs.

Grounding Begins Before the Session Starts

Therapeutic grounding is not something we switch on during the hardest sessions. It begins long before.

1. Pre-session intention setting
Clinicians who spend 30 seconds setting an intention often enter sessions more regulated. Examples:

• “I will stay curious.”

• “I will respond, not react.”

• “I can hold space without absorbing.”

• “My presence is enough.”

This small act starts the session with clarity and containment.

2. Regulated breathing before entering the room
A slow exhale activates the parasympathetic system more efficiently than any cognitive technique.

Try this:
Exhale fully for 6 seconds → Then inhale naturally → Repeat two times.

Your body shifts subtly but powerfully.

3. Boundary awareness
Therapeutic boundaries are not just ethical—they are energetic. Reminding yourself, “This is their experience, not mine,” helps anchor your system even before intense emotions appear.

Staying Present in the Middle of Intensity

The most important grounding skill during heightened sessions is awareness without alarm.

When a client expresses a surge of anger, sobs uncontrollably, or spirals into panic, clinicians may internally feel:

• “How do I help right now?”

• “Did I miss something?”

• “I’m losing control of the session.”

• “I need to fix this.”

These thoughts push us into reactivity.

Instead, we practice the art of internal spaciousness.

1. Notice your own body first
Check in silently:

• Where is my breath?

• Are my shoulders tensing?

• Am I leaning forward too much?

• Is my jaw tight?

You do not need to shift dramatically. A single unclenching is enough.

2. Widen your attention
When clients feel overwhelming, we tend to narrow our focus—which heightens tension.

Expand your attention to include:

• your breath

• the chair beneath you

• the room

• the space between you and the client

This creates emotional room without disconnecting.

3. Use a neutral, grounding tone
Your voice can regulate both nervous systems. A slow, soft, calm tone signals safety.

4. Anchor into your role
Remind yourself:
“I am the steady one in the room. I do not need their emotion to change before I become grounded.”

This is one of the most powerful grounding practices available.

Tools to Use When Emotion Rises Quickly

Here are in-session techniques that help therapists stay steady:

1. Micro-grounding
Move your toes in your shoes.
Touch two fingers together.
Let your shoulders drop ½ inch.
Shift your weight slightly.

No one can see it. But your nervous system feels it.

2. The therapeutic pause
A few seconds of silence slows the emotional acceleration and allows the client’s brain to recalibrate.

3. Reflective language over problem-solving
Instead of reacting with solutions, which increases your internal pressure, use grounding reflections:

• “Something really important is coming up for you.”

• “I’m here with you. You’re not alone in this.”

• “Let’s take a breath together before we keep exploring.”

This supports co-regulation while easing your own activation.

Why Maintaining Internal Balance Prevents Therapist Drift

When clinicians become overwhelmed in sessions, they may drift away from evidence-based practices. This usually happens because:

• The clinician becomes emotionally reactive

• The clinician becomes overly directive

• The clinician avoids certain topics to protect themselves

• The clinician shifts into rescuer mode

• The clinician disconnects to cope

Grounded presence allows us to:

• follow the treatment plan

• maintain pacing

• use interventions intentionally

• monitor our transference and countertransference

• stay aligned with best practice

A regulated therapist is more consistent, effective, and attuned.

After the Session: Resetting the Therapist Nervous System

High-intensity sessions require intentional recovery.

1. Take at least 60 seconds before your next session
Stand up.
Stretch.
Sip water.
Exhale slowly.

2. Release the emotional residue
Try: “This moment is complete. I return to myself.”

3. Journaling or case jotting
Two or three lines is enough to externalize what your nervous system absorbed.

4. Staffing, consultation, and supervision
Emotional intensity often carries themes—anger, trauma, helplessness, hopelessness—and discussing them prevents accumulation.

Your Presence Is the Intervention

The science is clear:
A regulated therapist helps the client’s brain access regulation they cannot achieve alone.

Your calm nervous system becomes a co-regulating anchor.
Your groundedness becomes a model of emotional leadership.
Your presence becomes treatment.

Clients do not need you to stop their emotion.
They need you to stay steady while they feel.

And you can.

Explore our free mental health resources. They may benefit your patients.
Download our FREE Mental Wellness Workbook and Therapy Themed Affirmation Cards, or share them with those you support:
https://www.serenepathways.com/free-offerings

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