I’ll give a big ‘ol caveat to what I’m about to say: I am, by no means, perfect at what I am advocating for here. Building distress tolerance for other peoples’ feelings, especially when one can easily interpret those feelings as a reflection of their professional skill, is hard as hell. It’s an active practice, not a fixed end point one can achieve. That said…
Y’all. We need to let our clients get upset (angry, terrified, panicked, devastated, euphoric) in session. The cultural preoccupation with being “regulated” has entered the therapy space in ways that have made many early career therapists struggle to see their clients’ big emotions as anything other than a problem to be fixed. People come to therapy presumably because they’re having some degree of a Bad Time; it’s not our job to make them stop having one! A major part of having a Bad Time is having big, scary, overwhelming emotions about whatever’s going on. Our job as therapists is not to make these emotions smaller or easier, it’s to help people learn to exist with and make meaning of them.
When we try to soothe our clients too quickly, we at best, do them a major disservice in their own ability to tolerate emotional difficulty. At worst, the urge to tamp down a client’s feelings perpetuates the historical legacy of psychology and social work as structural methods of social control, marginalization, and subjugation. Before we can understand what’s happening between therapist and client, we must first understand what’s happening between therapist and institution such that a preoccupation with regulating is seen as normative and not the result of a highly specific political history.
On that note: who do I mean when I talk about therapists as “we”?
Initially, I intended this article for any kind of therapist, but particularly early career ones who’ve maybe received shitty supervision around what it means when clients get upset. This is still true, but I also want to name that this essay is relevant, additionally in particular, for white therapists at all experience levels. It’s white therapists, I find, who have the most difficult time tolerating other people’s emotions and not taking them personally. This isn’t to say that Black therapists and therapists of color might struggle with this, too, but as white people we have specifically been conditioned to value our own comfort above all else. It becomes a clinical imperative, therefore, to treat our own whiteness the same way we would treat any other piece of countertransference material—with gravitas, humility, and a willingness to look at the ugliest parts of ourselves to do something with them. Now, let’s get into it:
The Nervous System Regulation Industrial Complex is rooted in, shockingly, white supremacy.
What the hell does being “regulated” even mean? Why is everyone talking about it these days? As a reductive overview: our nervous systems control the way we experience our feelings and the world around us. “Regulated” is when our parasympathetic nervous system is online; we feel calm, steady, and rooted in logical thinking. “Dysregulated” is when we’re in (real or perceived) danger, and our sympathetic nervous system takes over. Being dysregulated makes us feel as though we are, as is routinely described to me, “being hunted in the woods;” our heart rate increases, we get shaky, and we enter “fight or flight.”
The general cultural understanding of these phenomena seems to be regulation = good and dysregulation = bad. This is not surprising nor is it new. While the regulation model of understanding feelings can be incredibly useful, it can also be, on a macro scale, insidiously dangerous. This large-scale misinterpretation of regulation vs. dysregulation is simply the most recent way in which the field of psychology dovetails with the police state and white supremacy by enforcing socially acceptable ways of existing vs. not.
When people are dysregulated, they’re perceived as dangerous; this is especially true for BIPOC and other marginalized folks whose existence the fields of psychology and social work were created to police in the first place. Expressions of dysregulation (i.e. anger, fear, grief, overwhelm) have long been used as “reasons” as to why, for example, white cops have brutalized and murdered Black folks. White cops have “feared for their own lives” in the face of Black folks’ completely normal and non-dangerous expression of emotion and personhood, and even when Black folks have remained totally calm in the face of police harassment, white cops are still able to point to some kind of behavioral or emotional “deviance” as something scary enough to provoke police violence. This system of policing behavioral and emotional expression as evidence of safety vs. danger is by design, and it’s present at every level of institution, ranging from the carceral system to how “disruptive” kids are treated in school to how clients’ Big Feelings are treated by their therapists.
Not allowing our clients to get upset, have Big Feelings, become dysregulated in session is a function of white supremacy. It’s not a surprise that the cultural preoccupation with regulation has seemingly increased around the time that fascism has garnered an increasingly strong grip on the United States. Fascism feeds off of binary thinking to delineate who might be a threat to the fascist project vs. who might help further it. When we tamp down our clients’ Big Feelings, therapists, whether we mean to or not, contribute to this project.
We must learn: dysregulation does not automatically mean danger.
Part and parcel with the cultural preoccupation around regulation has been the popularization (weaponization) of language around emotional “safety” (if you exist in any kind of lefty subculture, you know exactly what I’m talking about). Because the cultural understanding is not only dysregulation = bad, but also dysregulation = DANGER, many young folks have accordingly internalized that anything that makes them uncomfortable must also be unsafe. This quickly snowballs from “X activity makes me anxious and therefore dysregulated, so it’s unsafe” to “this person makes me anxious and therefore dysregulated, so this whole ass person must be unsafe.” This then replicates the whole using-dysregulation-to-police-socially-acceptable-behavior thing, because “safety” is highly culturally contextual and is often in line with white supremacist ideals such that (usually, white) people can use their discomfort as a way to control the behavior of those around them. (See two paragraphs above).
When the sun is too bright or the kids on the train next to me are super loud, I get dysregulated, but it doesn’t mean I’m unsafe. Even scary feelings like rage or terror or grief aren’t unsafe in and of themselves. The goal of therapy is not to ensure that people never experience big, scary feelings ever again, but to help them learn to ride the emotional waves as they pop up.
But wait, isn’t clients learning how to regulate a good thing?
Yes, of course. The ability to regulate is crucial for emotional self-sufficiency and maintaining healthy relationships. Teaching clients how to regulate is important, but clients have to learn, specifically, how to self-regulate. If a client gets really Big emotionally in a session and you immediately move to help them calm down, they don’t actually learn how to self-regulate or self-soothe, because you’re doing it for them. Learning to take care of oneself emotionally is an extremely important aspect of therapeutic work; this is what, in part, helps clients stay emotionally functional in between therapy sessions, which is ultimately the goal of therapy!
I’m not saying that therapists can never help their clients regulate in session, nor am I saying that expressing Big Feelings in session is unilaterally helpful or clinically “productive.” What I’m saying is, ultimately, that Big Feelings and dysregulation are information. If we tamp down this information too quickly, we lose out on the opportunity to make meaning of that information and use it to move toward deeper growth.
With that in mind, let’s get into what happens when therapists can’t tolerate their clients’ Big Feelings:
Snuffing out clients’ Big Feelings robs them of an integral part of the human experience.
This might sound dramatic, but hear me out. If you’re a therapist, particularly one who’s early in their career, you probably internalized the message somewhere down the line that you are responsible for your client’s feelings (and behaviors). Therefore, if your client is having a big unpleasant feeling, it probably feels like they’re feeling that way because you’ve somehow failed to intervene perfectly such that they don’t have to feel their terror or grief or what-have-you. This is not true; the human experience is filled with a myriad of emotions, many of which are deeply unpleasant. You cannot prevent suffering, not for your clients and certainly not for yourself. Attempts to prevent suffering almost always breed anxiety, avoidance, and resentment, because preventing suffering is an impossible task that is always doomed to fail. It’s integral to the human condition to feel deeply, even, and especially, when feeling our feelings absolutely sucks. If a client starts to get angry in session, and you try to quiet them down, you are dulling an integral part of their human experience (to say nothing of how therapeutic it is to simply Be Witnessed in our rawest emotions).
Not letting clients get upset reinforces the idea that Big Feelings are unacceptable, unsafe, and must be avoided.
Being intolerant of clients’ Big Feelings, especially “negative” ones, usually becomes a parental enactment in which we signal that Big Feelings are bad, unacceptable, and makes them a bad child/client. Uncovering and inviting back in emotions that have been “disavowed” in childhood and letting them have a seat at the adult table is often the meat of the therapeutic work. If a client starts to ugly-cry in session and you try to assure them that things will be okay, you are covertly signaling that their grief is unwarranted and unnecessary, which exiles it deeper. Much of my work revolves around getting my clients to stop avoiding their feelings and start feeling them; I imagine it’s confusing when I encourage them to feel but then push them toward some kind of calming breathwork as soon as their anger or terror starts really coming out! Clients getting to experience their big scary emotions in the container of the therapeutic space is actually the thing that allows those emotions to become integrated and managed more easily outside of therapy. Tamping down my clients’ feelings on their behalf only teaches them that I don’t think they can be trusted with the intensity of their own feelings. Which leads us to:
Clients can only become as differentiated as their therapists are.
Differentiation, the ability to onto yourself while someone comes really close or moves far away emotionally, plays a crucial role in every relationship, especially the therapeutic one. If you feel the need to fuse with a client in some way when their emotions get big (i.e. immediately guiding them to regulating, taking the emotion personally, shying away from the client the bigger they get, etc.), then the client can’t learn to be with the discomfort of their Big Feelings without fear of major rupture with you. This is partly where the parental enactment mentioned above comes into play—if a client thinks that you will abandon them because they had a Big Feeling in front of you, then they’ll use whatever maladaptive strategies they need to make sure you stick around. Pushing for your clients to stay “regulated” all the time doesn’t teach them how to tolerate their own distress, and it inadvertently reinforces the idea that, in order for them to remain close to you (and others), they have to keep their Big Feelings under control.
We know that the secret sauce that makes therapy actually work is the therapeutic relationship itself. The strength of the therapeutic relationship can make the difference as to whether someone comes out as queer, leaves a harmful relationship, or is able to maintain some level of functioning through personal tragedy. Clients will confront the most shameful, terrifying parts of themselves when they feel deeply held by the strength of the therapeutic relationship.
The therapeutic relationship is powerful as fuck; denying this power is almost always how therapists harm their clients, purposely or not.
Tamping down clients’ Big Feelings also robs therapists the opportunity for critical countertransference work.
I once described being a therapist as “having to stay still in the eye of someone else’s emotional storm,” and I (mostly) stand by it. I don’t mean that you have to remain completely neutral while a client is sobbing or screaming at you, you can let yourself be swayed organically by the client’s show of emotion, but it does a disservice to both you and your client to try to quiet the storm itself.
I’ll give you an example. I worked with someone for a while who, on many occasions, would come into session and just scream for 50 minutes straight. In the beginning of our work together, this scared the shit out of me. I would try to pull them (and myself) back onto solid, familiar ground by giving them breathing exercises to do or trying to provide some kind of insight as to why they were so upset. It became clear pretty quickly that my urge to make them less distraught was for my own benefit, not theirs.
It was terrifying and frankly, dysregulating, to witness the depth of someone else’s grief and rage so intensely. But after some time, I was able to quiet myself down enough to let the client scream and cry without trying to stop them. It was then that I was able to take stock of what was happening for me as they cried—I was able to take in the empathy, yes, but also the boredom, distress, and frustration I felt about working with this client. I was surprised and a little ashamed to have such complex feelings about someone in such obvious pain; therapists are supposed to be perma-empathic and perfectly attuned to each client. But because I was able to face these emotions, I was able to do something with them, by which I mean I took them to supervision to make meaning of them and let them deepen my clinical practice.
Working with that client was difficult not because they themselves were difficult, but because being present with their Big Feelings brought me closer to my own Big Feelings. The process of learning this lesson was painful but ultimately I’m extremely glad I learned it. I’m no less afraid of my clients’ Big Feelings but I’m much more able to be open and curious about them without tamping them down first. I’m able to come closer to my clients without being afraid that I might flinch at their intensity or take on their feelings as mine. I can be a steadier, calmer presence regardless of how big they get. A client’s ability to Get Big in their emotions with their therapist can become a profound moment of intimacy and opportunity for healing. Clients being upset in session is a feature, not a bug, of therapy. It is the work. Do both of yourselves a favor; let them get upset.
Bravo!!! Once again, yes yes yes