The Day I Couldn’t Catch My Breath

I once left back-to-back sessions and sat in my car, hands gripping the steering wheel, heart racing. It wasn’t my client’s anxiety this time — it was mine. Somewhere between holding space for others and pushing through my schedule, I had absorbed so much that my nervous system was running on empty.

That day taught me something important: even as therapists, we are not immune to stress, dysregulation, or burnout. Our bodies keep the score, too.

Why This Matters for Therapists

Therapists spend countless hours teaching clients about grounding, nervous system regulation, and self-care. Yet, ironically, many of us fail to practice what we preach. Burnout and compassion fatigue rarely appear suddenly. Instead, they creep in through the missed breaks, shallow breaths, skipped meals, and the subtle ways we override our bodies’ signals.

When our nervous systems are dysregulated, it doesn’t just affect us. It shapes how we show up in the therapy room — our attunement, patience, and presence all depend on our physiological state. For us to do trauma-informed work well, we must extend that same care inward.

Hacks for Nervous System Regulation

1. Micro-Pauses Between Sessions

Even two minutes can reset your system. Step away from your screen, stand up, stretch, or simply place your hand on your heart and take a few intentional breaths. These micro-pauses act like nervous system “bookmarks” that keep you from carrying one client’s energy into the next session.

2. Polyvagal-Informed Breathing

Breath is one of the fastest ways to shift state. Try lengthening your exhale so it’s longer than your inhale. For example, inhale to a slow count of four, exhale to six. This activates the parasympathetic nervous system, signaling safety and calm.

3. Sensory Resets

Sometimes, regulation comes from shifting the environment. Step outside for a dose of fresh air, listen to bilateral or calming music, or change the lighting in your office. Small sensory resets help interrupt the buildup of stress.

Reflections:

• What subtle signs tell me I’m dysregulated during the day?

• Where can I insert short rituals of regulation between sessions?

• How do I know when I’ve crossed from healthy stress into early burnout?

Our nervous systems are the foundation of our clinical work. By tending to them, we not only protect ourselves from burnout but also model resilience and regulation for our clients. The work we do is demanding, but with intentional care, it doesn’t have to be depleting.

At EngagedMinds Continuing Education, we offer training designed to support therapists in both clinical skill-building and personal sustainability. Explore our upcoming workshops on trauma-informed care and nervous system regulation: EngagedMindsCE.com

References:

Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self-care. Journal of Clinical Psychology, 58(11), 1433–1441. https://doi.org/10.1002/jclp.10090

Lipsky, L. V. D., & Burk, C. (2009). Trauma stewardship: An everyday guide to caring for self while caring for others. San Francisco, CA: Berrett-Koehler.

Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. New York: W.W. Norton & Company.

Skovholt, T. M., & Trotter-Mathison, M. (2016). The resilient practitioner: Burnout prevention and self-care strategies for counselors, therapists, teachers, and health professionals (3rd ed.). New York: Routledge.