Do therapists cry in therapy? The role of experience and other factors in therapists’ tears.

Abstract

The subject of therapist's crying in therapy (TCIT) has been virtually ignored in the literature, with only 1 qualitative dissertation and 3 case studies devoted to the topic. This mixed-method survey study explored therapists' experiences with and attitude toward TCIT. Six hundred eighty-four U.S. psychologists and trainees filled out the survey online, revealing that 72% of therapists report having cried in therapy in their role as therapist. Data analysis indicated that the act of crying in therapy has less to do with personality or demographic factors (i.e., Big Five traits, empathy, sex) and more to do with the unique aspects of the therapy itself and the therapist's identity in the therapeutic context (theoretical orientation, clinical experience, affective tone of the session). Clinicians with more experience, who are older, cried more in therapy than novice clinicians, despite lower crying frequency in daily life, suggesting that more experienced therapists feel more comfortable allowing themselves to experience and/or express such emotions in therapy sessions. Psychodynamic therapists reported slightly higher rates of TCIT than cognitive-behavioral therapists despite no differences in crying in daily life. Despite significant differences in crying rates in daily life, male and female clinicians report similar rates of TCIT. Data regarding the relationship between TCIT and Big Five personality traits, empathy, and perceived consequences of TCIT are reported.

When Therapists Cry: Implications for Supervision and Training

“…Findings from these studies indicate that the majority of psychologists and psychology trainees will experience therapist crying in therapy (hereafter, TCIT) at some point in their career. Indeed, research reports that those therapists who cry in therapy cry in approximately 7% of therapy sessions (Blume-Marcovici et al, 2013). Compared to prior research that has found clients to cry in approximately 21% of therapy sessions (Trezza, Hastrup, & Kim, 1988), these numbers allow us to estimate that therapists cry in therapy approximately one third as often as their clients, though this percentage does not account for intensity or duration of tears.…”

“…Regarding sex of respondent, the women were more likely to receive supervision than the men despite equal rates of crying in therapy amongst men and women (Blume-Marcovici et al, 2013). In other words, male therapists are just as likely to experience TCIT as females, but they are less likely to disclose or discuss it with a supervisor or colleague.…”

“…In 1987, Pope, Tabachnick, and Keith-Spiegel published results of a survey on which 57% of their 456 psychotherapist respondents reported that they had cried in the presence of a client. More recently, Blume-Marcovici, Stolberg and Khademi (2013) reported that 72% of psychologists and psychology trainees had cried at least once during a therapy session with a client. Findings from these studies indicate that the majority of psychologists and psychology trainees will experience therapist crying in therapy (hereafter, TCIT) at some point in their career.…”

“…Although most of the time therapists reported that their tears were focused on the client, in 16% of cases therapists reported that their tears were related to their own (i.e., the therapist's) personal circumstance (Blume-Marcovici et al, 2015). And, although 82% of therapists reported that they believed TCIT helped the client feel that his/her therapist genuinely cared, 69% expressed concern that TCIT would cause the client to feel that the therapist would not be able to handle the client's emotion (Blume-Marcovici et al, 2013). Despite the fact that the majority of TCIT: SUPERVISION AND TRAINING 4 therapists believe TCIT can impact the therapy -in both positive and negative ways -no research exists regarding training, supervision, or consultation on TCIT.…”

“…Because researchers have previously found differences in the rates of TCIT based on clinician's level of experience and theoretical orientation (Blume-Marcovici, et al, 2013), and because of the documented differences in rates of crying between males and females in general (Bylsma, Vingerhoets, & Rottenberg, 2008;Vingerhoets, Cornelius, Van Heck, & Becht, 2000) despite similar rates of TCIT (Blume-Marcovici, et al, 2013), and since the expression of emotion is moderated by culturally determined display rules (Ekman, 1973;Matsumoto, 1989) and freedom of expression in a given culture (van Hemert, van de Vijver, & Vingerhoets, 2011), we also aimed to investigate whether any demographic or clinical experience variables were related to different experiences of training, supervision and consultation with respect to TCIT.…”