Therapeutic Immediacy: If Your Tears Could Speak, What Would They Say? 1

A clinical practice review of crying research.

“…Discussion of a therapist’s tears can also be viewed in the context of therapeutic immediacy, which refers to disclosures of the therapist’s feelings in reaction to their patient, patient’s reactions to the therapist, as well as the patient–therapist relationship, with a focus on the here and now of the experience (Hill, 2004; Hilsenroth et al, 2017; Mayotte-Blum et al, 2012). The discussion of episodes in which patients and therapists cry together may influence the patients’ beliefs about the expression of emotion, such that the patient can learn that crying is not something that should be condemned and avoided.…”

“…In that regard, the therapist’s expression of authentic affect (i.e., tears) allows the patient to safely focus on his or her own tears and related emotional experience. Such crying exchanges may facilitate the patient’s emotional authenticity by enabling him/her to learn how crying may increase closeness and comfort within the safety and comfort of the therapeutic relationship, allowing the patient to make meaning of tears in the context of these emotional transactions that can then be translated to the patient’s other interpersonal relationships (see Hilsenroth et al, 2017).…”

“…Crying in the context of psychotherapy along with therapist-guided processing via in-session discussion following the crying episode may provide clients with a template for more adaptive expressions of emotion in interpersonal relationships. Along these lines, the expression of intense emotional experiences through crying followed by positive and validating responses by the therapist may also allow clients to gradually learn to become more comfortable with their own emotional experience (see Hilsenroth, Mayotte-Blum, Kuutmann, & Umphlet, 2017).…”