Many articles about taking a break from counselling assume that therapy breaks are limited to a pause between a series of sessions or sometimes after only one session. But what happens when you need to take a break during the session itself? I explore this dilemma here.

Why Take a Break During a Session?

Washroom Breaks

Although this topic may seem awkward, weird or cringy within the context of a counselling discussion, I still think it’s worthwhile to note that when we are feeling anxious, as can often be the case in a therapy session, anxiety can increase the urgency around having to pee. And, understandable efforts to increase hydration or help with relaxation by sipping on a water or tea in your therapist’s office, only add to the situation.

Further, if you’re meeting with your counsellor in-person, without the convenience of home, you may find yourself rushing to make your appointment, believing you don’t have time to use the washroom beforehand, or, if the therapist does not have a gender-inclusive washroom, you may find yourself holding it.

Additionally, the need to pee frequently may also be related to other health conditions, or even pregnancy. There can be so many reasons to need to take a bio break in session!

Session is Overwhelming

Because of the nature of counselling, strong emotions can arise during a counselling session, which might feel overwhelming. Your therapist may or may not realize that this is happening for you, depending on how your anxiety is manifesting in the session.

Sometimes anxiety can be mitigated in the session itself, for example, if you are able to tell your therapist about it, or if your therapist recognizes what is happening and works with you to ground yourself. Sometimes the grounding can also come from the strength of the rapport you have with your counsellor: good rapport can be soothing and stabilizing in and of itself.

You may, however, feel an urge to leave the session—either momentarily or end the session early—in order to compose yourself, clear your mind or just take a few moments alone to breathe. This can actually be an empowering act, and be helpful long-term for assisting us in feeling agency and autonomy both within the counselling session and on a wider scale. Having agency within the session is particularly important you have fear about counselling, concerns about losing your autonomy or a history of feeling trapped in other areas of your life.

Situational Variables

For some people, attending counselling would not be possible, given their life circumstances, if there wasn’t at least some flexibility around a session being paused—at least momentarily. I think, for example, of midwives who may get an urgent call to a birth in a middle of a session. Rare, but possible. Or, in another example, a caregiver may need to take an urgent call during a session. And, more commonly–and as much as we try to avoid it–a package is being delivered mid-session and a delivery person needs to be let into the apartment building remotely! There could be a number of reasons.

What Is Hard About Breaks?

Any time a client has asked to take a break during a session, it is always accompanied by either an apology or a tentative note like “do you mind?” “is it ok?” or both, which has prompted me to ponder the possible reasons that are contributing to this hesitation, over and above the reasons for breaking, noted above.

No social script around breaks

Because I see myself as a counsellor who often writes about unusual nuances of counselling, and because not much has been written on the topic of in-session breaks, from this I’ve deduced that there is not much of a social script around it. How do we participate in what we need if we don’t know if it’s ok?

Neurodivergence

While I can and will never speak for neurodivergent folks as a whole, many of us have trouble deciphering what is “acceptable” in a situation or how to proceed when a situation is ambiguous. Is it appropriate or ok to take a break, even if our nervous systems are screaming for one?

People-pleasing tendencies

Many of us have learned to people-please growing up;  harmony can feel emotionally safer than conflict, particularly if conflict was taken to an extreme and could become dangerous. People-pleasing often becomes a reflex to the point that we never want to make waves and self-advocacy does not feel like an option.

Not wanting to “waste” money

Sometimes if might feel like we are “wasting” precious time and money if we take a break, given the cost of psychotherapy these days. While this is understandable, physical or emotional distress that might benefit from a break may overshadow the quality of the session anyways, leading us to question whether we are, indeed, getting good value for our money.

Socialization

I’ve heard it a million times and while it is a stereotype, Canadians do have the reputation for being polite and saying sorry. And then for some of us, throw in being born female, and we have a double-trouble situation, socialization-wise, when it comes to speaking up about a break.

Ways to Break

I like to think that the impetus to break in session can also be an inspiration to practice the art of “breaking” in other life scenarios. Here are my thoughts:

Honour Your Needs

When you reflect internally, do you have a sense that a break in the action would be helpful? If discerning your internal state is too hard, are there outward signs, based on past experience, that indicate that pausing would make a difference? If it’s hard to honour your instinct, would you be up for a small pause to see how it goes? Did it help or not? Ultimately, honouring our needs has tremendous implications for other qualities that we are working to develop: self-trust, assertiveness, self-care, self-compassion, nervous system regulation and more.

Practice Assertiveness

This can be difficult to do without support, but exercises like DEAR MAN, or the support of a therapist can help! There are many benefits of assertiveness which include promoting autonomy, self-confidence, self-respect and making choices that have more positive results.

Therapist Support

Choose a therapist that will respect your need to take a break, whether that’s in session or in-between sessions. While therapists may initially indicate surprise about or even recommend against breaks, this is usually due to concerns about interrupting your progress in therapy. However, they should also be willing to hear and trust your opinion!

Avoiding Disruptive Breaks

Sometimes breaks in a session are neither intended, nor wanted. Examples can include receiving notifications during a session or your session being interrupted by someone else. Small acts like turning notifications off or letting family members or roommates know not to interrupt you in session can help. Some folks find it helpful to have their virtual session away from a home workspace to create distance from workplace worries.

Whether or not in-sessions breaks are relevant for you, I encourage you to reflect on the value of breaks in everyday life!