Crying during sessions

[LadyHalcyon]

Just wanted to know other's thoughts on crying during a therapy session. It typically only happens a few times a year, usually when my empathy becomes slightly overwhelming and/or during termination sessions with clients I have a strong bond with. It's never uncontrollable and is more along the lines of becoming "teary". I have a few different thoughts on this. One being that it is authentic emotion and expresses my empathy toward the client. The other being that it could be too overwhelming for the client and pull for them "taking care" of me. Anyway, this isn't something I've really addressed often in past supervision so I thought I would get some input.

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[Spydra]

My first thought is how is your self care? I get that some people are more the crying type than others, but it doesn't seem appropriate for a therapist to be crying in session. If this is happening then perhaps you need to do more to decompress after working with clients or maybe there are other stressful things happening in your life that need to be addressed.

 

[MCParent]

Depends what “a few times a year” means. Like 3 times out of 300 contact hours, or 30/300? I probably wouldn’t care about the former but the latter would be concerning. Also matters the population; tearing up at a shelter prac a few times is different from sobbing because someone is having trouble picking a major at the career center.

 

[foreverbull]

My supervisors on internship and beyond were more positive in their framework around crying and its genuine expression (tearing up, not intense sobbing, I should add), as long as it's occasional (termination, or something with big emotional impact) and not a regular thing, which is an obvious caveat that most professionals would know already. I don't see it as a negative phenomenon or a problem when it's rare.

 

[cara susanna]

I've cried a handful of times (not like sobbing, but teary-eyed) and IMO it's just a natural human response. If it's happening a lot, that may be concerning, but who wouldn't be sad over some of the things we hear?

 

[futureapppsy2]

I don't think that showing empathy via becoming teary eyed is inherently bad, per se, but I do think it can impact clients and make them feel like they should attend to your distress or not bring up that topic, which can be potentially very negative, especially with things like SI.

 

[foreverbull]

I don't think that showing empathy via becoming teary eyed is inherently bad, per se, but I do think it can impact clients and make them feel like they should attend to your distress or not bring up that topic, which can be potentially very negative, especially with things like SI.

Tears can also be a great interpersonal opportunity to process those concerns and reflect that behavior from your client if you notice your client trying to take care of you. Interpersonal approaches allow for that kind of processing to bring that to light as a teachable moment in a relationship rather than see it as a risk/problem. My assumption is that you probably have a good rapport/relationship built up first.

If you get embarrassed by being teary-eyed once in a blue moon with a client, they may see that as you modeling emotional avoidance, for example, so also modeling our humaneness can be positive as long as it isn't taken to an extreme.

 

[Justanothergrad]

The question is always "does it promote better client focused care or does it distract from it"

 

[smalltownpsych]

The times I have teared up in session have typically been helpful. Much of the time it is a way to model a healthy emotional response. I also will occasionally express anger in a session too. I tend to be fairly emotionally expressive individual anyway and some of that is cultural which also brings up the point that cultural and family of origin dynamics play a role in this as well. My own personal opinion, based on years of patient's descriptions of what they have found helpful, is that the extremes are the problem. In other words, don't be the emotionless blank slate that hides behind a clipboard or the gushy cry at the drop of a hat type so that patient worries about how to help you. One of my supervisors liked to overgeneralize and say that half of our patients are too emotional and can't think and the other half are unable to express emotions and think too much. As Linehan likes to say when quoting some zen stuff, "walk the middle path".

 

[LadyHalcyon]

Depends what “a few times a year” means. Like 3 times out of 300 contact hours, or 30/300? I probably wouldn’t care about the former but the latter would be concerning. Also matters the population; tearing up at a shelter prac a few times is different from sobbing because someone is having trouble picking a major at the career center.

Well so far this year it's been once out of 550 direct hours

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[LadyHalcyon]

My supervisors on internship and beyond were more positive in their framework around crying and its genuine expression (tearing up, not intense sobbing, I should add), as long as it's occasional (termination, or something with big emotional impact) and not a regular thing, which is an obvious caveat that most professionals would know already. I don't see it as a negative phenomenon or a problem when it's rare.

It's definitely not a regular thing and it's usually only with one or two clients a year. Also, it tends to occur when terminating (80% of the time)

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[LadyHalcyon]

I don't think that showing empathy via becoming teary eyed is inherently bad, per se, but I do think it can impact clients and make them feel like they should attend to your distress or not bring up that topic, which can be potentially very negative, especially with things like SI.

That is my main concern

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[MCParent]

Well so far this year it's been once out of 550 direct hours

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I think *I* teared up more than once every 500 hours, and I'm not a crier.

You're fine.

 

[Kadhir]

I'm extremely averse to crying in session or otherwise, reserving this only for the Olympics. This is why I went into neuropsychology.

(joking)(not entirely)