Intense emotions are like a fire in the room. Just like firefighters run to the flames, therapists need to adopt that same fearless stance in the face of dysregulation flames. These moments can feel intimidating, but they are still workable with the right preparation. Firefighters never enter a scene without training and the right tools, and therapists shouldn’t either. This blog will walk you through some tools you need to handle emotional escalation in session.

Take Care of You: How to Keep Your Cool

Staying grounded in the face of intense emotion is not a personality trait. It is a deliberate skill set. Below are some practices that keep you steady when a client’s intensity feels overwhelming.

1. Know What You’re Afraid Of

Every therapist has fears that get activated in high intensity. You may fear losing control of the room. You may fear saying the wrong thing. You may fear that the client’s emotion means you have failed. You may fear losing a client.

If you don’t know your fear, you’ll react to the fear instead of responding to the client.
Lean into the thing you are afraid of and let it be part of your landscape instead of something you spend your career avoiding. If you are afraid of being a failure, make peace with the possibility of failing. Carry it with you rather than fighting it. This means you stop trying to get rid of your fear and allow it to be there while you keep doing your job. When you stop resisting it, the fear moves into the background and loses its power instead of taking over. This is how you build clinical fearlessness. Not by pretending you are unaffected, but by teaching your nervous system that these moments are survivable and not dangerous.

2. Create a Regulation Plan

Therapists often talk about regulation with clients but rely on muscle memory for themselves. You need a plan. Something written down, practiced, and integrated.

Start by identifying your early warning signs of activation. Notice if you tense up, speed up, hold your breath, or mentally check out. Pay attention to the urges that show up too. Do you want to fix the client’s pain immediately? Do you want to reassure, redirect, or move away from the intensity?

Then outline the exact steps that bring your body and mind back into balance.

The goal is not to escape the discomfort but to tolerate it.

3. Recover After the Session

Therapists need a recovery plan as well. Regulating in the middle of intensity takes energy. You are not expected to stay in firefighter mode once the session ends. Give yourself structured time to de-escalate. Set a timer and treat those minutes as part of the work, not extra.

Do something grounding. Put distance between you and the emotional heat you just held.

4. Turn Down Your Empathy When Necessary

Dial your empathy down to a workable level. Stay connected without being absorbed. Stay attuned without matching their intensity. You’re allowed to hold some distance. You’re allowed to think, “This feeling belongs to them, not me.” The client’s pain is real, but it is still theirs. Their emotion isn’t yours to take home. This is the boundary that keeps you useful.

Take Care of Your Client: How to Fight the Fire with Your Client

Once you’re steady, and using your validation and compassion skills as the backdrop, your task is guide the session. That includes letting emotions run their course, helping the client stay with discomfort, challenging unhelpful signals, and using creativity or irreverence when the room gets stuck.

1. Everything Is Going To Be Okay

The first tool is understanding the limits and nature of emotion. Emotions surge, peak, and fall. It feels urgent, but it is not an emergency. The body is built to regulate itself, and it will settle when given the chance.

Clients need space to feel what they feel. When a therapist rushes to calm someone down, it confirms that the emotion is dangerous, urgent, and something they must get rid of immediately. That message reinforces dysregulation, not safety.

Allow the feeling to move through its natural arc. Your internal stance is: “This is a moment. We can handle moments.”

2. Emotional Exposure With Your Client

Help your client face the moment rather than search for a way out, and support them in building the courage to stay with what feels overwhelming.

Pay attention to the signals that say, “Fix this for me.” “Avoid this with me.” and don’t fall for the trap.

Honor the work without doing the work. Phrases like:

“You’re doing a great job staying with this.”
“I know this is hard, and I also know you can do it.”
“You’re such a badass right now.”

These kinds of statements help clients build confidence in themselves and their capacity to stay present.

Tools for supporting clients through overwhelming emotions

3. Don’t Trust Every Emotion

Intense feelings can feel convincing, but not every emotion is an accurate signal. Our brain can send alarms that don’t match reality. Help your clients understand this and help them turn their pre-frontal cortex back on.

Sometimes the most powerful move is not calming the emotion but mentally stepping above it. Some examples of this stance can look like:

“Thank you for trying to protect me, but you’ve got it wrong this time.”
“This emotion is loud, but I’m choosing reason.”
“I’m not letting this feeling run the show.”

From here, clients begin to understand that they can acknowledge a feeling without surrendering to it.

Techniques therapists use to regulate themselves during dysregulated sessions

4. It’s Okay If It’s Hard

Sometimes your clients will face things in their lives that you have never had to face. Their pain may be deeper, their circumstances more complex, and their history more overwhelming. This can create an urge to rescue or protect them from the intensity because it’s just so shocking. Protecting them from difficulty deprives them of the chance to build the muscles they actually really need. They still have to face what is in front of them, even when the deck is brutally stacked. You can ask them to meet hard moments, even when their circumstances feel impossibly unfair.

How clinicians manage their own activation when emotions escalate.

5. Do Not Fight Resistance

Many therapists become flustered when clients refuse a skill or shut down.

If a client says, “I’m not doing distress tolerance skills,” the instinct is to convince, soothe, or negotiate. A stronger move is to let the resistance land.

“Alright. What’s your plan instead.”

This puts the responsibility back where it belongs, while honoring the client’s agency. In fact, it often reduces resistance faster than persuasion ever will.

How therapists guide clients through dysregulation without rescuing

7. Drop the Therapy Voice and Lean Into Your Humanity

When we become dysregulated or afraid we can become overly formal and buttoned up.

It’s performative, not authentic. Clients feel it when you switch into a therapy voice. It reflects the therapist managing their own discomfort rather than responding to the client.

Speak the way you actually speak. If you curse in real life, curse when it fits. If you are naturally direct, stay direct. Clients in crisis respond to realness, not performance. Your true voice communicates something grounding:

“I’m here and I’m not scared of this.”

Two humans, one emotional moment, nothing to fear.

help clients regulate overwhelming emotions

8. Use Irreverence to Break the Spell

Irreverence is a deliberate, unexpected shift in tone or behavior that interrupts an unhelpful emotional pattern. It adds surprise, lightness, or directness to break emotional tunnel vision and create enough space for perspective to return. Escalation narrows people into the same predictable moves. Irreverence disrupts the trance.

Examples:
“Wait. Who said you had to believe that thought.”
“Okay, let’s step back. This feeling is loud, but it’s not a dictator.”
“Hold on. This sounds like fear pretending to be logic.”
“Your anxiety is very committed to this plotline.”
“I know you too well to let you convince me that you’re a terrible person.”

Or don’t be afraid to do something weird. The element of surprise is very powerful in shifting emotions. I’m not afraid to embarrass myself in front of a client, because even a WTF reaction is a new perspective compared to the emotional tunnel they were stuck in.

Let’s get weird
Pick up a prop phone (I have a vintage rotary phone in my office) and say, “Hold on, I’m calling all the people who hate you,” wait a few seconds, then saying, “Weird… no one picked up.”
Say “If we’re going to worry, we need our worry hats,” and put on a literal hat labeled worry hat.

Conclusion

Stepping into intense emotion with a client is like stepping toward a fire. It requires training and the willingness to move toward the heat instead of away from it. When therapists do this well, clients finally experience what it feels like to be held by someone who isn’t scared of their intensity. That is where change begins.

At Sagebrush Psychotherapy, this work is our specialty. We work with clients who feel “too much” and whose emotions escalate quickly. We help people build the capacity to face their emotions instead of being controlled by them. This is the heart of our Fearlessly Compassionate approach.

If you are a therapist wanting to strengthen your own work with high-intensity clients, I also offer consultation. Reach out if you want support as you build your clinical fearlessness.

Therapists As Firefighters: How To Manage Intense Emotional Dysregulation in the Therapy Room