Stepping in and holding back
During or after a session with a deeply distressed client, I often catch myself thinking, ‘All I did was listen’. I also hear supervisees say the same. In those moments, we forget that listening – giving someone in distress our full attention – is hard. It asks us to sit with suffering and with the difficult feelings it stirs in us, while resisting the urge to move too quickly into offering tools, reassurance, comfort or advice.
When we intervene too quickly, we may be trying to relieve our own discomfort and helplessness, operating from within the frame of our own trauma, than responding to the client’s needs. Sometimes what a client most needs is someone who can bear the unbearable alongside them, so they do not feel quite so alone with it. Yet holding back carries its own risks. Clients in distress may long for guidance, reassurance or a sense of hope, and can feel frustrated, abandoned or let down when these are not forthcoming.
Few things test our judgment about when to step in and when to stay with the client’s experience more than suicidality. A client expressing a wish to die can trigger an immediate impulse to assess risk and formulate an action plan. Sometimes that is necessary. But first we must ask: who am I doing this for? Is it for the client, or to reassure myself that I have acted should they later harm themselves?
If our response is an immediate need to do something, we risk communicating that we cannot tolerate the client’s distress without taking control. Rather than strengthening safety in the therapeutic relationship, we may leave them regretting what they disclosed and deciding not to return. Yet if we take the opposite course of action, they may feel unsupported, without enough sense that there is something to hold onto.
Clients may need space to say what feels otherwise unsayable, without us immediately shifting into action mode. Working with risk requires us to tolerate our own anxiety amid competing pressures. For many people, speaking openly about suicidal thoughts is itself profoundly risky, often bound up with shame, failure, helplessness and weakness.
A recent BACP survey on men’s mental health found that 37% of the 2,500 men surveyed cited fear of appearing weak as a barrier to seeking therapy, while 34% believed men should deal with problems alone. Men account for 74% of suicides in the UK,¹ prompting BACP to warn of a ‘crisis point culture’ that prevents many from seeking support.
The need for spaces where clients – including men – can experience the healing that comes from being truly listened to is more vital now than ever. Listening is not passive. It means respecting a client’s autonomy and capacity to take responsibility for their own life, while also offering the care, concern and guidance they may need to stay alive. Therapeutic work continually asks us to hold the tension between stepping in and holding back, nowhere more so than when safeguarding concerns are present.
Reference
1. Office for National Statistics. Suicides in England and Wales: 1981 to 2024. https://tinyurl.com/2vvhd4e3 (accessed 29 April 2026).
This is an edited extract from an editorial first published in Private Practice, June 2026, published by BACP©