Setting Therapeutic Presence

Last month in my August blog I explored the words agenda and intention and how they can affect your treatment sessions. A large piece of getting our agendas out of the way is creating a therapeutic presence. When we do not set that presence we can feel as though our energy is drained and we are tired by the end of the day when working with people. Sometimes we can feel not grounded when emotional issues arise or we “take on” the client’s physical and emotional issues.

When working with the body, especially the subtle body, it is important to have a therapeutic presence in order to better feel the craniosacral, lymphatic, and vascular rhythms. But regardless of the type of therapy you provide the result of your session is largely influenced by your ability hold a safe, grounding, and healing presence. I call this unseen, unspoken connection you have with each client a therapeutic presence. You, as the therapist, feel grounded and not tired, your client feels safe and relaxed.

Often times as therapists (it is in our nature) we want our clients to be 100% better all at once. We are empathetic and try to “fix” things. We give a lot of ourselves without checking in to make sure we are staying present and grounded. We pay more attention to the needs of our clients then our own needs.  

To me, if I can stay in touch with my own needs and nurture myself, I set that tone for others and set a catalyst for healing and relaxation. When my own reservoir is full I am able to set a strong therapeutic presence. Your clients are able to tell when you are present, trust builds, and sessions can be more relaxing, safe and healing. Developing this skill also keeps us from burning out and engaged in the work that we do.

This past year I have been exploring some different options and ideas to keep me “full” and to set a strong presence. I have also been doing some online reading and research for more ideas. Below are some ideas and questions that might help you. Even if you do not work as a therapist these activities might help you to relax overall.

Before each session: I like to physically ground myself. I put my feet firmly on the ground, feel my sit bones in my chair, and my hands resting on my lap. I imagine being connected to the earth and take deep breaths. I let go of anything that is not going to help me in my next session.

During each session: If I find myself becoming ungrounded, especially if the client is getting emotional, I remind myself of the feeling of the earth beneath my feet, I take a few deep breaths and remember that connected feeling. Maintain clear boundaries, sometimes it might be best to refer out if you are unable to hold a space for your client. Listen to your body; are you becoming tense or sad as your client talks? If you are how can you still be present without adding your own emotion to what your client is saying or doing? Listen carefully to your clients and the words they use, what are the patterns? Honor your clients where they are right now and don’t try to change them or tell them what to do. Vision your clients as healthy, whole beings free of pain and capable of healing. Be aware when your own emotions are triggered and how to handle them.

End of session: Acknowledge your client, what they processed, and the courage it took. Make suggestions for follow up work or referrals to other practitioners as needed. Help them see the big picture if they are stuck on today only. Once the client is gone check in with yourself and ask if you were able to stay grounded, where you able to just be with them rather then give or deplete yourself? If you feel depleted what can you do to re-ground before going home or seeing your next client? Sometimes I visualize myself in a peaceful place and I calm and relaxed, or I imagine all of my client’s energy that I may have picked up leaving my body, or do simple breath-work.     

In addition I have to do other things to keep me “full” not just during my workdays but everyday. Daily I find that I have to check in with myself and ask: “what do I need to do today to best help me feel full emotionally and energetically?” Sometimes that is yoga, or riding my bike. Some days I need to take time to myself to walk the dog or be in nature or just sit and read a book. Often I do not have that much time so lately I have been using short breathing activities in the morning, between clients, and before I go to bed. I found a short mindfulness app that I am doing daily that has helped me tune out and check in. (check out

Taking time before you see clients and/or taking 10 or 15 minutes each day to do what fills you up will change your therapeutic presence immensely. You will be protecting yourself from burn out and clients will feel that presence. They will feel relaxed and healing will be facilitated. What are you doing each day? Does anyone do some of the same things I do? What are other ideas? I’d love to hear what you have to say!         


Intentions Versus Agendas in Bodywork