crying in therapy

When we think of psychology sessions, an image often comes to mind: a tearful individual pouring their heart out on a therapist’s couch. While tears indeed have their place in therapy, the reality about crying in therapy is far more nuanced. For example, people who are depressed are not more likely to cry, despite the common misconceptions. So, let’s set aside the clichés and understand what crying means in therapy sessions.

Is it normal to cry in therapy?

It is OK to cry in therapy, as you will likely talk about painful experiences and emotions. However, crying in front of a psychologist is not as common as one might think: only about 1 in 5 people cry in therapy sessions. Interestingly, 90% of those who cry are typically female, while only 10% are male. This ratio is true outside of therapy rooms, as ladies report nearly five times as many instances of crying per month compared to men.

How do we rate the session when we cry?

There are significant differences in how we rate a therapy session, based on whether we cry or do not cry. Research suggests that a patient’s overall experience of the session, ranging from negative to positive, changes depending on whether they cry or not. Similarly, they experience the session as more smooth if they do not cry. Lastly, the perceived positivity of the session showed a similar relationship.

These correlations suggest that the more often a patient cries during a session, the more difficult, the less smooth, and the more negatively they rate the session. At the same time, interestingly, crying was not associated with the perceived depth of or arousal during the session.

At face value, we might think that crying is bad for progress and that both the patient and the clinician should do everything possible to avoid crying.  

Is crying in Therapy bad then?

Based on the above, if we cry in a session, we will feel less good about the session overall. However, the most important predictor of recovery is the strength of the alliance between you and your therapist. Importantly, neither the clinicians nor the patient rated the relationship more negatively based on crying. In other words, there are no significant correlations between either patient-rated or therapist-rated alliance and the number of crying events.

This means that sometimes it might be okay to cry, even if the session is perceived a bit more negative. In other words, neither the therapist nor the patient should try to avoid crying, as we will see later, these uncomfortable sessions might contribute to better outcomes at the end of therapy.

Who is likely to cry during therapy sessions?

Individuals with higher levels of personal, occupational, and social functioning generally cry less in therapy sessions. This makes sense: the more balanced we are across the three key areas in our lives, the less likely it is that we will have intense emotions we cannot control.

There are significant positive correlations between crying and certain dimensions related to borderline personality disorder (BPD), emotional dysregulation scores, and being a victim of childhood sexual abuse. Emotion dysregulation, a core challenge of BPD, makes it more difficult to manage our emotions, we often feel them stronger but feel less control over them.

In simpler terms, individuals who exhibit more features associated with a borderline personality disorder diagnosis, higher emotional dysregulation, or greater severity of childhood sexual abuse tend to cry more frequently during their psychotherapy sessions.

Is crying good for therapy?

People who cried during therapy sessions demonstrated substantial changes by the end of the therapy, raising the question of whether crying might be actually beneficial, or at least, not detrimental to therapy. 

As we noted earlier, despite feeling that the session is more challenging when we cry, the therapeutic alliance remained unaffected. These positive results may suggest that effective therapy often involves an element of discomfort. This is, in fact, often a big difference between therapy and counselling: therapy aims at changing longstanding dysfunctions, and it is challenging and often not pleasant.

In conclusion, understanding the nuances of emotions, including the role of crying in psychology sessions, can contribute to a more insightful therapeutic journey. It’s important to recognize that each individual’s experience is unique, and tears can be a natural part of the process. If you find yourself contemplating therapy, consider taking that important step towards self-discovery and mental well-being. Seeking guidance from a psychologist provides a supportive space to explore your emotions and work towards a healthier, more balanced life. Remember, reaching out for help is a sign of strength.

Please note that this blog post by Personal Psychology, offering counselling in North Sydney, is not intended to provide professional advice. If you or someone you know is experiencing mental health difficulties, it is important to seek help from a qualified healthcare professional.