Clients often enter psychotherapy with struggles and concerns related to their direct experience of emotion. Though most of the major psychotherapy theories in the West address the general issue of emotion, very few have developed a framework or theory for supporting clients in their direct encounters with difficult feeling states. Since Buddhism is highly experiential and Buddhist philosophy is mainly concerned with the issue of human suffering, its relevance to maneuvering difficult emotions in a clinical context is profound. While the use of Buddhist concepts and practices in mental health treatment in the West has proliferated in recent years, the clinical use of Buddhist material has often bypassed the larger philosophical framework of Buddhism. This secular, decontextualized use of Buddhist material has limited the potential value of Buddhist philosophy in mental health treatment. This dissertation offers a conceptual framework for approaching difficult emotions that is grounded in the wisdom of Buddhism. Zen Buddhism is especially relied upon in the development of the following themes: Sitting With, Middle Path, Healthy Interdependency, and Compassion. Further, clinical composite case vignettes are presented to demonstrate how the themes can be worked with in a therapeutic context.