Upsetting Experiences for the Therapist In-Session

Several major schools of psychotherapy require a genuine emotional presence from therapists in-session, as well as a nondefensive awareness of their emotional responses to the client. The present article addresses the part played by upsetting experiences in the context of these requirements. In order to identify relevant issues for a discussion of the literature, grounded theory analysis is presented of a series of conversations with four psychotherapists about their experience with in-session distress. The participants reported client confrontation and rejection evoked a variety of negative emotions ranging from helplessness to anger. Besides traditional professional resources like supervision and personal therapy, they discussed several coping strategies that focused on emotions. One strategy that stood out was to analyze how the emotional impact occurred in order to clarify client issues. This strategy was reported to yield information that improved therapeutic effectiveness in the case at hand, but it also was an effective method for overcoming therapist distress and a means of promoting broader professional growth. These observations suggest issues for integrative psychotherapy research into emotional risk taken by therapists and its payoff.