Neuroscience
How often do therapists cry in therapy and does it matter? For a profession that trades in emotions, you'd think these questions would have been tackled before. But as Amy Blume-Marcovici and her colleagues point out in their new paper, the issue has been strangely neglected. There's been plenty of research on crying medics, yet all we know about crying therapists comes from an ethics paper published in the 80s (56.5% of therapists said they'd cried in front of a client), and an unpublished qualitative study of ten psychodynamic psychotherapists for a doctoral thesis completed in the 90s.
From their survey of 684 US psychological therapists (75% were women; age range 22 to 85; 35% CBT, 23% eclectic with psychodynamic emphasis, 19% eclectic without psychodynamic emphasis) Blume-Marcovici's group found that 72% of the sample had cried in therapy ever. Among these criers, 30% had cried in the last four weeks.
Looking at the correlates of being a therapist who cries in therapy, it was older, more experienced therapists and those with a psychodynamic approach, who were more likely to be criers. Surprisingly perhaps, female therapists were no more likely to cry in therapy than male therapists, despite the fact that they reported crying more often in daily life than the men.
This mismatch between crying in everyday life and crying in therapy was a consistent theme. Older therapists too cried less often in daily life than younger therapists, despite more crying with clients. Also, whereas crying in daily life is typically associated with negative emotion, in therapy it was associated not just with the therapists experiencing sadness (reported by 75% during their last therapy cry), but also with "feeling touched" (63%), warmth (33%), gratitude (15%) and joy (12%). "This suggests that tears that occur in the therapy situation are different in nature than tears shed in daily life," the researchers said. However, it's worth noting that, at their last time of crying in therapy, the therapists believed their clients were experiencing negative emotions like sadness, grief and powerlessness.
Therapist personality was only weakly related to crying, with openness being the most relevant trait. More agreeable and extraverted therapists also showed a tendency towards crying more. The personality questionnaire used in this study was extremely brief, so it's tricky to read too much into these results. Ditto for therapist empathy, which showed an association with crying tendency, but not frequency or proneness, possibly due to the limitations of the empathy scale that was used.
This research provides no objective data on the effect on clients of having a crying therapist. However, the therapists' belief was that their crying was either inconsequential (53.5%) or that it had changed their relationship with their client for the better (45.7%). Less than one per cent felt it had harmed their client. Referring to the literature on therapist self-disclosure, the researchers speculated that perhaps therapist crying has a positive impact when the therapist-client relationship is already strong, but can threaten that relationship when it is weak or negative.
Blume-Marcovici and her colleagues called for more research on this neglected topic, and particularly for future studies to investigate the effect of therapist crying on client outcomes. They said their initial results are "meaningful" because they challenge the idea that "therapist crying in therapy is occurring due to the therapist being overwhelmed by intense negative emotions that arise in therapy, and instead signals a moment of potentially positive emotional connection, even if amid painful negative affect."
_________________________________
Blume-Marcovici, A., Stolberg, R., and Khademi, M. (2013). Do Therapists Cry in Therapy? The Role of Experience and Other Factors in Therapists' Tears. Psychotherapy DOI: 10.1037/a0031384
--Further reading--
When therapists have the hots for their clients
What should a therapist do if a client confesses to murder?
Successful therapists focus on their clients' strengths
Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.
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Neuroscience
Older, more experienced therapists cry more often in therapy
From their survey of 684 US psychological therapists (75% were women; age range 22 to 85; 35% CBT, 23% eclectic with psychodynamic emphasis, 19% eclectic without psychodynamic emphasis) Blume-Marcovici's group found that 72% of the sample had cried in therapy ever. Among these criers, 30% had cried in the last four weeks.
Looking at the correlates of being a therapist who cries in therapy, it was older, more experienced therapists and those with a psychodynamic approach, who were more likely to be criers. Surprisingly perhaps, female therapists were no more likely to cry in therapy than male therapists, despite the fact that they reported crying more often in daily life than the men.
This mismatch between crying in everyday life and crying in therapy was a consistent theme. Older therapists too cried less often in daily life than younger therapists, despite more crying with clients. Also, whereas crying in daily life is typically associated with negative emotion, in therapy it was associated not just with the therapists experiencing sadness (reported by 75% during their last therapy cry), but also with "feeling touched" (63%), warmth (33%), gratitude (15%) and joy (12%). "This suggests that tears that occur in the therapy situation are different in nature than tears shed in daily life," the researchers said. However, it's worth noting that, at their last time of crying in therapy, the therapists believed their clients were experiencing negative emotions like sadness, grief and powerlessness.
Therapist personality was only weakly related to crying, with openness being the most relevant trait. More agreeable and extraverted therapists also showed a tendency towards crying more. The personality questionnaire used in this study was extremely brief, so it's tricky to read too much into these results. Ditto for therapist empathy, which showed an association with crying tendency, but not frequency or proneness, possibly due to the limitations of the empathy scale that was used.
This research provides no objective data on the effect on clients of having a crying therapist. However, the therapists' belief was that their crying was either inconsequential (53.5%) or that it had changed their relationship with their client for the better (45.7%). Less than one per cent felt it had harmed their client. Referring to the literature on therapist self-disclosure, the researchers speculated that perhaps therapist crying has a positive impact when the therapist-client relationship is already strong, but can threaten that relationship when it is weak or negative.
Blume-Marcovici and her colleagues called for more research on this neglected topic, and particularly for future studies to investigate the effect of therapist crying on client outcomes. They said their initial results are "meaningful" because they challenge the idea that "therapist crying in therapy is occurring due to the therapist being overwhelmed by intense negative emotions that arise in therapy, and instead signals a moment of potentially positive emotional connection, even if amid painful negative affect."
_________________________________
Blume-Marcovici, A., Stolberg, R., and Khademi, M. (2013). Do Therapists Cry in Therapy? The Role of Experience and Other Factors in Therapists' Tears. Psychotherapy DOI: 10.1037/a0031384
--Further reading--
When therapists have the hots for their clients
What should a therapist do if a client confesses to murder?
Successful therapists focus on their clients' strengths
Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.
- What Happens When Therapists Dream About Their Clients?
We often dream about what we've been doing and who we've been with, so it should come as little surprise to discover many psychotherapists dream about their clients. In fact a new study reports that nearly 70 per cent of thirteen participating...
- Can Therapists Tell When Their Clients Have Deteriorated?
About five to ten per cent of the time, people in therapy get worse instead of better. What should psychotherapists do in such cases? Hang on a minute. There's no point answering that question unless therapists can recognise that a client has deteriorated...
- Successful Therapists Focus On Their Clients' Strengths
Research is increasingly showing that the success of therapy depends not on the theoretical orientation of the therapist, but on key therapeutic processes that cross theoretical boundaries. Two such processes are ‘problem activation’ – helping...
- Is It Really True That Therapists Don't Improve With Experience?
When choosing a therapist, you’d be forgiven for wanting someone with plenty of experience. But then you might well be unaware of all the studies that, to psychotherapy’s embarrassment, have failed to find any association between therapist experience...
- Cognitive Therapy On The Couch
Cognitive therapy for depression could be improved by the therapist focusing more on the therapeutic process itself. That’s according to Jonathan Kanter (University of Wisconsin-Milwaukee) and colleagues who compared the effectiveness of therapy given...