Being an LGBTQ+ Affirming Therapist (Part 1) I Think I’m Getting Triggered in Session

Being an LGBTQ+ affirmative therapist takes intention, knowledge, and skill. But what if you get triggered in session? 

First of all, let’s acknowledge that triggers happen. We bring our whole selves to the table – including our personal history, our trauma, and our experiences of marginalization. We all have tender spots. That’s just being human. 

To get a little vulnerable for a moment, here’s a glimpse at what that might look like for me: I’ve been through a divorce, and sometimes when the topic of divorce comes up in session, I can feel that history coming back. When that happens, I take a moment to remind myself that every experience of separation is different. The clients in front of me will have different pain points than I had. If they are talking about a really bad fight that reminds me of something I lived through, it doesn't mean their experience is the same as mine was. 

I think we’re sometimes scared to talk about this aspect of our experience. We might worry that it will make us sound unprofessional, or like ineffective therapists. And maybe for some of you it sounds like transference 101! But it’s still worth talking about. 

Triggers and Identity

For LGBTQ+ clinicians, our shared experiences can help us bond deeply with our clients, but they can also amplify our sensitivity to certain topics. When we work with clients whose identities are similar to ours, hearing about their stories and experiences may be more likely to touch on our own personal sore spots. At the same time, that shared understanding is a powerful resource for connection and healing. 

That said, overlapping identity doesn’t mean that we all have the same experiences! LGBTQ+ identity is a great big tent, defined by diversity; and even with a lot of overlap, everyone has a unique life path, and it’s easy to go astray when you make too many assumptions about your similarity with your client. 

On the other hand, a lack of familiarity with a specific cultural context creates blind spots, which can then lead to unhelpful reactions in the moment. I’ve heard plenty of stories from clients who noticed their therapist make a subtle “wince” when they mentioned non-monogamy, kink, or a specific sexual interaction. These non-verbal cues can undermine the therapeutic alliance. If you’ve found yourself unexpectedly thrown off in a moment like that, it’s a hint that it might be a good moment for a continuing education mission. 

No matter who you are, and no matter who you’re working with, you can find yourself thrown off in session – whether by a painful resonance from your own life, or by a totally unexpected curveball. In other words, if we want to provide the best care we can, we all have to find a way to effectively prepare for and manage our triggers. 

By the way – no matter what your identity is, the fact that you’ve read this far shows that you’re committed to doing the best by your clients. This work isn’t easy, no matter where we’re coming from. Thank you for openness, your vulnerability, and your care for your clients. 

Know yourself

Start by identifying what happens in your body when you get triggered:

• Do your muscles tense up? 
• Does your heart race? 
• Do you start to feel vague, foggy, or frozen? 

Understanding these physical signals can help you recognize when you’re starting to feel overwhelmed. We teach our clients how to regulate and be more embodied, and it can be powerful to model what we teach. The first step is self-awareness. 

Next, reflect on the topics or situations that are likely to trigger you. If you anticipate a specific theme may arise during a session—perhaps related to relationships, identity, or community experiences—plan ahead. Think about how you want to react when something catches you off guard. 

Role-playing conversations is a great tool. Enlist a friend or colleague and run through a few possible scenarios. The power of roleplaying is that it allows you to experience and prepare for the actual in-the-moment sensation of being thrown off or triggered, and you can start to develop a repertoire for responding in the moment. 

In the moment: Get grounded

When you start to notice signs of being triggered, tap into your body. 

• Are you taking deep breaths? 
• Slow down; there’s no need to react immediately. 
• Remind yourself of your purpose in the session. Focus on the next intervention and center yourself in the therapeutic plan you’ve created.

Reconnect with your mission

It’s essential to stay clear on the underlying plan and purpose for your choices in session. That helps to maintain focus on the process and the client’s needs, rather than being sidetracked by your emotional responses. When you get triggered, after you’ve taken a moment to recenter yourself, you can tap back into that mission. 

Reflect on your responses

Take a moment and think through your last clinical week. For me, there was a moment when I found myself incredibly angry in a session. I was learning about something my client's parent did; the story brought up some of my own personal stuff, and I reacted to it. Before I could move forward, I had to become aware of what was going on in my own body. 

It was useful to reflect afterwards on what it was that that moment had called up for me. In that vein, here’s a simple exercise to help you develop a deeper understanding of what tends to trigger you:

• Make a note each day of any times you felt triggered in session. 
• After a week or two, take a look back over what you’ve written, and see if you can notice any themes. 

(We'll come back to this exercise in the next installment of this series.) 

We are all works in progress, and navigating triggers is an ongoing journey – and while our sore spots can be a challenge, they’re also an opportunity to lean in and learn more, about ourselves, our clients, and our communities. 

By the way – this is part one of a three-part series. The next installment will be about how to find support around our anticipated triggers, and the final installment will be all about how to make an effective repair as a therapist.