Do Psychotherapists Cry During Therapy Sessions?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Do psychotherapists cry during the session, and if so, how often do they cry, and how does it affect their clients? Unfortunately, in the literature you can find a very meager number of reports on this topic. However, there is some evidence for crying psychotherapists. In a study by Blume-Markovich and colleagues, it was found that 72% of all psychotherapists who participated in the study cried at least once during their entire practice while working in a psychotherapy session. Among those who had experienced their own crying during therapy, 30% cried at least 4 weeks before the start of the study.

It turned out that experienced older psychotherapists who practice the psychodynamic approach cry more. No gender specificity was revealed: both men and women psychotherapists cry equally often during sessions, although women psychotherapists cry more often in everyday life.

The discrepancy between crying during therapy and everyday life has surfaced repeatedly in the study. Senior psychotherapists are less likely to cry in daily life than their younger counterparts, but they are more likely to cry with their clients. Tears in everyday life are more often associated with negative emotions, but in psychotherapists, during work, this state is associated with intense positive experiences.

Therapists reported that when they cried during therapy, they experienced not only sadness, but also a “feeling of belonging,” warmth, gratitude, and joy.

The relationship between the personality traits of therapists and the tendency to cry during the session was weak. The psychotherapists themselves believed that their crying either did not affect the therapy process in any way (53.5%), or changed the relationship with the client for the better (45.7%). Less than one percent of psychotherapists felt they had harmed a client.

In his work "The Inner World of Trauma" D. Kalshed gives the following example from practice. In dealing with the cumulative childhood trauma from which his client, referred to by the author in this work Mrs. Y, suffered, Kalshed observes a common inability for such clients to remember a specific traumatic event and an inability to emotionally relive the traumatic experience. One day, while at her mother's house, a client of Kalshed found some old home films that were filmed when she was 2 years old.

Looking through one of the tapes, Mrs. Y saw herself, a skinny 2-year-old girl just above the knees of an adult, running from one pair of legs to the other, crying. Her gaze begged for help; rejected, she rushed with entreaty to the other pair of legs, until, overwhelmed by grief, the nurse came up to her and led her away. The next day Mrs. Y spoke about it during the session in her usual dispassionate manner, humor hiding her sadness. Deep down she seemed very upset.

So, by chance, access to the client's strong feelings was opened and, in order not to miss this chance, Kalshed invited her to hold a special session, which would be dedicated to the joint viewing of this tape.

As expected, this new situation was somewhat awkward for both the patient and me. However, after we had a little joke and laughed at our mutual awkwardness, she calmed down and talked freely about the people who appeared on the screen as the events on the screen gradually approached the episode that she had spoken about in the previous session. And so we watched together the events of a desperate drama that was played out about 55 years ago and captured on film. We watched this portion of the film again and when we watched Mrs. Y again. burst into tears. I found that my eyes were full of tears, and these tears, it seemed to me then, went unnoticed by the patient. Her composure quickly returned to Mrs. Y, but immediately she burst into tears again. We experienced together genuine grief and sympathy for her childish self, who was in despair; her struggle to regain her composure, which was accompanied by self-deprecating remarks about "weakness" and "hysteria", her awkward attempts to convince me that everything is fine with her and everything will soon pass.

In the next session, at the beginning of which there was every now and then pauses filled with awkward silence, we began to discuss what had happened.

“You were human last time,” she said, “before you offered to watch this film together and I saw your tears, I tried to keep you at a fair distance. My first reaction was the thought, “My God, I didn't mean to… make you so upset. Forgive me, this will never happen again! " “It’s unacceptable and terrible to worry you in any way. However, deep down, it touched me deeply and was pleasant. You were so human. I could not get it out of my head,”she continued:“Over and over again I repeated to myself: “You touched him! you touched him! He is not indifferent and cares about you! “. It was a very exciting experience. I will never forget this session! It felt like the beginning of something new. All my defenses were thrown back. I woke up late at night and wrote about it in my diary."

I am always very excited when, in the process of reading the next work on psychotherapy, I discover something unexpected, something that is not usually written or talked about. The straightforwardness and sincerity of Kalshed's story at first took me by surprise, I was confused and perplexed, never before had I encountered a crying therapist. The reaction of the client to his tears is very clear to me. Yet the therapist's reaction was difficult to integrate into my experience, and the attitude towards what I read was not determined in any way. I needed to do something to somehow cope with the new questions. I started doing small research with my colleagues. I showed a fragment of Kalshed's case to several therapists I knew, changing the author's designation "Mrs. Y." to reduce the persistent influence of authority on the results of the assessment ("Mrs. Y." obviously indicates that the therapist is "overseas", and "overseas" is always more honored and respect), in general, I tried to present everything in such a way that this therapist is somewhere among us, one of us, from our "fatherland", and therefore not a prophet; also from the fragment I submitted it was not obvious what gender the therapist who burst into tears was.

In my small study, 22 therapists were involved, aged 30 to 45, practicing from one to 18 years of age, 17 of whom were women. The overwhelming majority of therapists practice a client-centered approach (10), slightly less - Gestalt therapy (6), the rest - psychoanalytic (4) and cognitive-behavioral therapy (2).

An interesting nuance emerged in my research: male therapists practically did not pay attention to the therapist's tears, and were more involved in the discussion of the appropriateness of conducting a "special session". In contrast to the statements of male therapists, female therapists, with the exception of one, immediately noted the therapist's tearful reactions. Some “justified” (6 therapists) and “accepted” (6 therapists) the crying therapist, others (4 therapists) attacked with harsh criticism, saying: “The therapist for supervision!”

Analyzing the statements of women therapists, I correlated them with (given thesis):

- The ego ideal manifested in the "justifying" therapists, that is, with the authority in the face of which they gave their answers and wanted to look their best;

- the ideal Ego, on behalf of which therapists expressed their acceptance of the crying therapist, the reason for the desire in this case is to look like receiving therapists in the eyes of other people;

- the super-ego - a cruel ridiculing and punishing instance that defines the crying therapist as sinful, vicious, defective and condemns to supervision.

Inner freedom is a quality that is considered an attribute of an effective therapist in various schools and directions of psychotherapy, sometimes diametrically opposed in their conceptual concepts. For KCP, the emphasis on freedom and spontaneity, the correspondence between feelings, thoughts and actions of the therapist is seen as one of the necessary and sufficient conditions for changing the client. Thinking one thing, saying another thing, feeling the third thing, and doing the fourth thing is really bad for a KCP representative. Let me remind you what was the core of Mrs. Y's suffering - “some part of her herself was isolated and did not take part in the relationship,” we are talking about a dissociated traumatic experience. While not an example of wholeness and unity, the therapist is far from the accompanying experiences of well-being and harmony. It is therefore not surprising that the overwhelming majority of female therapists, whose statements indicated justification or support for the crying therapist, belonged to the client-centered camp of psychotherapists.

To date, my colleagues and I are closely and seriously engaged in the study of expressive reactions of therapists during therapy, in particular the tendency to cry during therapy sessions. I hope that our research will be able to somehow fill the gap in this, as it turned out, little popular topic. In addition, it is most interesting to investigate how clients feel about such manifestations of the therapist.

Effective psychotherapy leads to the fact that the space of freedom, initially limited by the framework of the psychotherapeutic session, inevitably expands for the client. Such studies, as I have already managed to make sure, expand the space of freedom, limited by the framework of our convictions, in which, as it turns out, no one even convinced us.