“Happy New Year??” may just be the quintessential opening sentiment of 2022. The Omicron variant of Covid 19 is currently raging; uncharacteristically, Vancouver was under a prolonged white blanket of snow, which turned to treacherous ice; the Metro Vancouver area faced, yet again, another “atmospheric river” triggering trauma for many folks from last year’s floods in the Fraser Valley. There is a lot to cry about these days.

So at the risk of this turning into an ‘anti-New Year’ article, I’ll stop here and turn toward the more general topic of crying in therapy.

Assumptions

I’ve often heard people say that crying is a given in therapy. And in many ways, it’s a reasonable assumption to make because many of us who have been in therapy have had this experience. Yet we all have a different relationship with our tears: some cry frequently in a counselling session, others, sporadically, and still others never cry at all. Some cry silently, others weep loudly and sometimes eyes mist up and sometimes tears rush like a river. If I’ve learned something over the years, it’s that humans are diverse and there is no one right way of expressing tears (or not) in a counselling session.

But any assumptions we may have about crying in counselling can be limiting when we think that we “should” be acting in a certain way or that we are “not getting enough” from therapy if we don’t ball our eyes out.

What Triggers Crying

While I could generate a list of topics that generally make people cry, I’m not interested in unnecessarily triggering folks. Further, it’s often the emotional relationship we have with the painful circumstance(s), and not just the situation itself, that is most important, as humans vary widely in their responses to even similar things.

Common emotions which can stir up tears:

• Grief/Loss
• Shame
• Hurt
• Betrayal
• Sadness
• Anger/Frustration/Outrage
• Disempowerment/Injustice
• Desperation
• Joy/Happiness
• Empathy/Compassion
• Vulnerability
• Regret
• Loneliness
• Longing

When The Tears Come

People have a variety of responses to crying in a therapy session.

In stereotypical Canadian fashion, many are apologetic about their tears, although from the therapist’s point of view, there is absolutely no need to be. A number of us, growing up, were told to “stop your crying,” or have experience with sociocultural environments where crying, or the general expression of emotions is unacceptable. In other instances, clients may feel embarrassed about crying and cringe at the attention they worry it brings to them. Still for others, crying may intensify feelings of vulnerability.

But others are grateful for the opportunity to cry in session. “I feel a lot better,” “I needed that” or “I felt really heard,” are examples of positive responses to one’s tears.

When You Don’t Cry

As noted above, we may have grown up in stigmatizing environments where it was not ok to cry, or where there were spoken or unspoken family rules against crying, or where culturally, it isn’t common. We may also feel trapped in rigid gender roles which dictate that crying is unacceptable.

In the therapy environment, counsellors will often see a correlation between lack of tears and trauma, which can be an indication that the client has dissociated from their trauma as a means of surviving it.

For others who have not cried in some time, and crying in a session would not feel accessible or ‘natural.’

And therapists should never assume that what a client is describing should invoke or involve tears. That’s for counselling clients to decide.

When Therapists Cry

It’s no secret that therapists are often deeply affected by what their clients are expressing in counselling. And despite stereotypes that therapists are detached and robotic, I don’t relate to this and the therapists I have had over the years have conveyed authenticity and warmth.

Opinions in the counselling field—including those of both therapists and clients—are mixed about whether or not counsellors crying in session is appropriate.

For those in favour, positive factors associated with therapists crying may include: that the therapist’s tears are an expression of genuineness, the recognition that the therapist is human and relatable, an increased equalization of the power dynamic in the therapeutic relationship and a confirmation that the therapist cares about the client and their experience.

But not everyone agrees that therapist-crying is a good thing. Over the course of my career, the biggest concern I have heard from both therapists and clients is the potential for a counsellor’s tears to burden the client. And whether or not clients are conscious of being burdened, they may still feel responsible for looking after the therapist emotionally, which is not their job.

Crying Complications – Phone and Video Sessions

The Covid pandemic has produced a dramatic turnaround in the way that therapy sessions are delivered Prior to the pandemic, in-person sessions were king and video and phone sessions were distant runners up.

But therapy delivered by phone and video poses some unique challenges for therapists attempting to gauge crying in a session. Most commonly, because of the lack of visual cues with phone sessions, counsellors do not always know if a client is crying, particularly when they are crying silently or very quietly or in other more idiosyncratic situations such as when the therapist has some hearing loss. Sometimes the only indication is a long pause, although this is not a guarantee of what is going on as this could also be related to poor reception! But for some, none of this is a barrier as it may feel much more comfortable not to be “seen” by a therapist, as it may allow tears to flow more easily.

Video quality with poor resolution, inadequate lighting/clients that are backlit or lags in the video related to weak Internet, all can contribute to problems for the therapist in detecting and responding to clients’ tears. A failure to respond if the therapist is not aware of the above, may unfortunately come across to clients as a lack of care or compassion. If you think your therapist has not responded appropriately to you in session, please bring it up with them! A discussion will usually clear things up for the better or, if their response is unsatisfactory to you, help you understand that the therapeutic fit may not be right.

Unlike the old days when I would buy high-quality tissue in bulk which I would pass to clients in session, if clients are at home for their session and attending virtually, they may not have tissue handy or may reach for the next best thing (toilet paper, paper towel etc.) which may feel fine or conversely, a downgrade in self-care.

Crying may also be impeded if there are others in and around the living space where a client is having their session. While I always ask clients, who are attending virtually, to ensure that they have privacy for their session, simply the mere presence of someone else in the house can be enough to make one feel self-conscious and unable to express tears freely.

Session Self Care

Some time ago I wrote an article about counselling session aftercare strategies, because of the emotional toll that a counselling session can bring, even if very beneficial. When tears are involved, one’s body may feel more exhausted than usual, provoking the need for a break, rest, renewal or refreshment. You may also need additional time to reflect, and if needed, re-process your feelings in your next session with your therapist.

A Few Notes For (Interested) Therapists

If you’re a therapist reading this, you may not be looking for my opinion about how to handle tears in a session. I’m just one therapist who approaches things in the best way I know. You may, then, want to stop reading here. If you’re curious about how I see things, here are my thoughts:

Genuine expressions of therapist emotion, including tears, cannot necessarily be controlled. Certainly, most therapists do not try to force themselves to cry in a session, and may be surprised if tears well up. One’s tears, however, should be acknowledged, and clients reassured, that they are not responsible for “fixing” the situation. It may be important to ask your client how they felt about your tears and to genuinely respond to any concerns. Re-grounding oneself in session is important and if emotion continues beyond that moment and lingers long past the session’s end, I recommend that you consult with your clinical supervisor (I hope you have one!).

It goes without saying that clients experience emotions in a range of different ways and we should not expect a certain “standard” around emotional expression. Profuse crying—unless there is a safety risk—should not be judged, just as we should not judge a lack of crying, even if we think it’s warranted. If dissociation is at play, although it may not be considered “ideal,” it is in itself a coping strategy, and finding alternatives takes time, and trust. You can, however, assist your client in coming back into the present moment, or offer strategies to help re-regulate the nervous system, if they are willing to accept your help.

And if you think that there is something you are uncertain a client wants to talk about, and that could elicit strong emotions, including tears, asking consent first is a very good idea.