What emotional reactions can quietly reveal in clinical work
There are moments in therapy when our emotional response feels louder than usual.
A client frustrates us. Leaves us feeling flat. Evokes irritation, helplessness, protectiveness, or an urge to rescue. Sometimes we notice it clearly. Other times, it shows up more subtly in how we tighten, disengage, or overwork during the session.
These reactions can be unsettling.
Many clinicians worry that having strong feelings means they are doing something wrong. That they should be more neutral. More contained. More professional. Especially early in practice, emotional reactions can feel like a personal failure rather than part of the work.
I remember supervising a clinician who spoke about a client she dreaded seeing on her calendar. Nothing overtly difficult happened in their sessions. The client was polite, consistent, and engaged. And yet, every week, the clinician felt unusually tired afterwards and found herself thinking about the client long after the session ended.
She was confused and slightly ashamed by this. “They’re not really doing anything wrong,” she said. “So why do I feel this way?”
Other times, the disconnect with a client is far more obvious. It might be a client who questions every response we offer, huffs at a suggested strategy, or loudly declares that therapy has never worked for them, sometimes within minutes of walking into their first session.
These moments can provoke an immediate internal response. Defensiveness. Self-doubt. A pull to justify ourselves, work harder, or retreat. The reaction is often quick and visceral.
In both cases, whether subtle or overt, the emotional response is rarely random.
As we explored things further in supervision, it became clear that my supervisee’s reaction was not a mistake. The client’s way of relating mirrored something familiar from her own life. The emotional response was information. A quiet transference.
Our responses in the room are shaped by the client’s patterns, the relational field that forms between us, and our own histories, limits, and vulnerabilities. When we pay attention to these reactions rather than pushing them away, they often tell us something important about what is happening beneath the surface.
This does not mean we should act on every feeling or make the therapy about us. It means becoming curious about what our internal experience might be signalling. Sometimes it points to a dynamic the client cannot yet articulate. Sometimes it highlights a boundary that needs strengthening. Sometimes it simply tells us we are being affected.
Ignoring these reactions does not make them disappear. More often, they leak out in ways that are harder to name. Over-structuring. Withdrawing emotionally. Becoming overly directive. Or quietly dreading the work (cue the sinking feeling when you see that client’s name on your list for the day).
Learning to notice and reflect on emotional responses is part of developing clinical judgment. It is not something to rush or resolve quickly. It is something to bring to supervision, to think about carefully, and to hold with humility.
Strong reactions do not mean you are unskilled. Often, they mean you are engaged in meaningful relational work. It’s how we approach our reactions that matters.
To Sit With This Week
- Notice which clients evoke stronger emotional responses in you, both positive and negative.
- Gently reflect on what those feelings might be telling you about the relational dynamic.
- Ask yourself whether your reaction invites curiosity, whether a boundary needs to be strengthened, or support from a colleague to debrief and explore may be helpful.
- Pay attention to how unacknowledged reactions may be shaping your behaviour in the room.
- Remind yourself that being affected is not the same as being unprofessional.
Finally, there are situations we reflect on that indicate that we are not the right clinician for this client, and that’s okay too! Having the insight to refer on when appropriate is not a weakness, it's a strength.
Thank you for sitting with me in the clinical space this week.
Warmly,
Psychologist and Principal, My Thriving Mind