Q: I find myself getting extremely reactive when clients lose their temper in my office. What can I do to better control my anger and anxiety in the presence of an angry client?
A: Most therapists are trained to process emotional reactivity by examining content: "Why do I feel this way about this client?" They may be able to take the edge off their anger by realizing, for example, that this not their father or some other authority figure disregarding their feelings; rather, this is a client, a troubled person who has come to them for help. The only problem with this strategy is that anger arises faster than thoughts do. "Working it through" keeps you several steps behind an angry client, like poor Dr. Melfi struggling with Tony Soprano.
Like soldiers, therapists need self-regulation skills that kick in automatically under fire, and developing them is akin to undergoing basic training. These skills must become automatic--conditioned responses to fight-or-flight cues--so that the experience of anger and fear triggers them. In fact, the skills that will help you in sessions are the same ones your clients need to reduce the level of anger and resentment in their own lives.
One method of developing a conditioned response to regulate emotions is a technique called HEALS, which has proven as successful with clients as it has with me. The technique is aimed at producing an immediate and unconscious response that transforms…