I agree with what Scarlet said about grounding skills and finding ways to regulate a little better before you reach that state of utter pain and aloneness. I've gotten better at noticing when I'm reaching the edge of my window of tolerance and telling my therapist, and I can tell that she's getting better at seeing it too. We've tried a variety of things: throwing a ball back and forth, standing up and moving around, focusing on a picture of her dogs and talking about them, lighting a candle, touching her special fuzzy pillow, etc. This past week she pulled an aromatherapy thingy out of her desk and offered to let me smell it. Sometimes the focusing on a sensory thing helps but sometimes even just the very act of trying something together (and shifting focus for a few minutes) makes me feel like she's still there to help me and stops me from getting outside my window of tolerance. Otherwise if I just keep talking about what's upsetting me, I end up feeling like a house on fire regardless of what she says.

That said, my T is interpersonally quite open and warm, and she is open to touch including hugs and pats on the back/upper arm and stuff. I do think it feels different that I know I can get that from her, so I don't want to say that grounding skills alone are necessarily going to be enough if that desire for touch is so powerful it overrides everything else.