A Triggered Therapist: How to Stay Present When the Work Gets Personal

There are moments when it’s unmistakable you’re triggered in session. Recently, I felt a quickening tension in my chest during a session. A client spoke, and something in me pulled away. My mouth kept forming words that sounded professional, but my nervous system had traveled somewhere old and familiar.

Activation can arrive like that—sudden and sharp. But more often, it creeps in slowly: a fog in my forehead, a thin numbness, a slight drift from presence. In our field, these experiences are usually discussed only in extremes—burnout, rupture, crisis. But there’s a vast middle ground we rarely name. In these “unprecedented times,” therapists need an honest, everyday language for what happens to us under constant pressure.

Being Human in the Room

We don’t stop being human when we become clinicians. We each carry our own histories. We breathe the same cultural and political air as our clients. We, too, carry grief—and sometimes that grief bubbles to the surface when we sit with someone working through something familiar.

The term countertransference only goes so far. It doesn’t quite capture the visceral hit: a jolt in the chest, a drop in the gut, a sudden flare or shut-down before any thought arrives.

My work is in religious trauma recovery. I’m still unraveling my own conditioning from fundamentalist systems. Sometimes, old echoes surprise me. In the past, those moments would spiral into shame. You should be able to hold this, I’d tell myself, even if you have no idea how. I’d try to push through, pretending it wasn’t happening.

But I’ve learned that denying activation doesn’t make it go away. It makes it louder. What restores clarity is honest contact with my own inner state.

The Subtle Work of Staying Present

We're taught to keep the work "clean"—to stay neutral, contained, as if our own reactions might damage the alliance. But most of what we feel in session isn't harming anything. It's information: tightening in the chest, a momentary freeze, a drift into fog. The body registers what the mind hasn't yet named.

Presence isn’t about ignoring what you feel to focus on the client. It’s relational: to the moment, to the other, and to yourself. When something surfaces, the nervous system wants simplicity. Exhale longer. Notice your feet. Soften your shoulders. Name the truth—I’m activated right now—and stay.

Notice the tenderness. That’s information. That’s part of how we navigate.

In the past, I’d default to autopilot—words flowing while contact thinned. But lately, I’ve been doing it differently. When there’s space, I’ll invite a shared pause: a grounding breath, a slower pace, a moment to re-center. Repair often happens in those tiny shifts, without needing to name them aloud. Presence comes through refusing to abandon what’s actually happening.

When we treat our own emotional life with the same care we offer clients, we stop abandoning ourselves in the work. Compassion sharpens. Boundaries strengthen. What clients need isn’t perfection—they need a human being who knows how to come back.

Reframing Professionalism in a Shifting World

This world is heavy. Clinicians are carrying grief, anger, and fatigue even as we sit with others. Much of our training didn’t prepare us for this. That doesn’t mean we’re failing. It means we’re being asked to evolve.

That evolution might look like slowing down. Letting the client lead. Or noticing that in some moments, the most skillful move is staying with your own emotional truth, rather than distancing from it. We can expand the frame without losing our integrity.

Because presence—especially when it’s hard—is part of the work now. Modeling our humanity, without collapsing into it, might be one of the most healing things we can offer.

A Reflection for Fellow Therapists

If you’re reading this, take a breath. Ask yourself:

• What helps you stay grounded when the work hits close to home?

• How do you return to yourself when something gets stirred?

I’d love to hear what you’re learning. This is the conversation we need more of.