When Self-Doubt Strikes Mid-Session: Grounding Strategies for Highly Sensitive Therapists
You're in your comfy therapist chair, sipping your coffee (or tea), fresh morning sunlight pouring in through your window, and you're feeling solid about the work you're doing with this client. Things haven't been progressing as quickly as you would like, but you're starting to see some glimmers of change.
As you reflect this most recent shift in how your client named their emotion, your client looks at you and says, "Yeah, but it wasn't enough. I still went into my anxiety spiral and spent the rest of the night obsessing about what I did wrong. Then I couldn't sleep and I feel like crap today. I just don't know if therapy is working."
Whooof, your stomach sinks and sinks some more, and you feel kinda sick. Your body is flooded with anxiety and, let's be honest, some despair.
Imposter Syndrome in Highly Sensitive Therapists: You're Not Alone
Your own thoughts spiral —
I suck.
I'm no good at this.
I'm not helping her.
I'm a failure.
What am I even doing here?
If you're like me, self-doubt and imposter syndrome lurk nearby and are quick to speak up at the first sign that something isn't going smoothly. And, a comment from someone else that feels negative — even if my therapist self can see that this is important to explore — and points to me or my work not being good is enough to get the voice of doubt screaming in my head.
So, in the moment, you know you need to get grounded to process what your client said. In reality, it's really, really, really hard when your sensitive nervous system is hijacked.
I get it.
I also know how resourceful we are and what inner strength we possess to help us get through these moments. We have a lifetime of experience coping with our sensitive bodies.
6 Grounding Strategies for HSP Therapists When Triggered in Session
Here are some things that have helped me in moments like this:
1. Acknowledge Your Feelings — Then Set Them Aside Temporarily
Validate my feelings internally and then stuff that shit away (for now). I try to remind myself that this is hard and my thoughts and feelings matter, but I need to come back to them later. I imagine a cardboard box way down on a tall shelf and I try to shove all my stuff into that box to return to later.
2. Use Grounding Imagery: Roots Into the Earth
Imagine roots growing through feet down deep into earth. I love nature and I find being connected to it very comforting. Picturing roots growing out of my feet through the floor and down deep into the earth feels very grounding. It helps me feel more solid when my insides are wobbly. This is a powerful somatic grounding technique for highly sensitive people.
3. The Waterfall Visualization for Emotional Boundaries
When my client is talking about something that is bringing up strong feelings in me, it helps if I imagine a waterfall between myself and my client. I can still hear and process what they're sharing, but the movement of the water feels like it keeps things flowing and can help me wash away things that I don't need or want to take into my own body. This visualization supports healthy boundaries for empaths and HSP therapists.
4. Lean on Motivational Interviewing OARS Techniques
MI OARS is particularly helpful when I'm having a lot of feels. It seems to give me some personal distance from what is being explored while also grounding me in the work and giving me something concrete to focus on. I know how to ask open-ended questions (O) and provide affirmations (A), reflections (R), and summarizing (S). Returning to a familiar clinical framework is especially helpful for therapists managing self-doubt in session.
5. Give Yourself Time Before Processing — Don't React When Flooded
I have learned that when I'm flooded with feelings it does me no good to process them right away. I'm so off kilter after being triggered that my reactions and ability to make meaning are waaay off too. I really need a night's sleep — and sometimes 2 or 3 or 4 — before I have a clearer perspective. Making myself wait can feel really hard, especially when my brain is obsessing and wants to gnaw on what's happened. I often need A LOT of distraction and have to redirect myself frequently, but waiting does usually help me in the long run. This is a critical strategy for HSP therapist emotional regulation.
6. Seek Consultation and Validation From a Trusted Colleague
Of course, peer consultation and validation from a trusted colleague can help tremendously. For me, I do usually still need some time and distance from what's happened before I can really benefit and take this in. Peer support is an underutilized resource for sensitive therapists battling imposter syndrome.
The Gift and Challenge of Being a Sensitive Therapist
It's hard enough being human and holding space for another human to work through their deep inner dramas. When we add in our sensitive nervous systems, it can feel completely overwhelming. But we all develop our resources to help us navigate these challenges.
As a sensitive therapist, what helps you when you get triggered in a session?
We got this,
Ivy