Crying in therapy: how important is it?


I’m one of those people who believes crying is the most effective way a patient can both (a) release emotion and purge buried hurt and pain; and (2) connect with others, especially in a therapeutic setting. The irony here is that I’m also one of those people who has a great deal of difficulty crying in front of others, including therapists. I feel like tears are expected of me, and that tends to inhibit me even more. I don’t like feeling like I have to “perform.” However, alone, I have retrained myself to cry and now can do so quite easily. That’s been a huge breakthrough for me. It’s doing it in front of anyone else where I run into issues.

Why cry?
Most people with NPD (not so much BPD–who tend to be cryers anyway–and people with PTSD/C-PTSD could go either way) probably find it difficult or even impossible to cry in therapy–after all, being too vulnerable is what a person with NPD fears the most, and yet it’s that very vulnerability that led to their need for an “invulnerable” false self in the first place. Narcissists started life so sensitive that they had no natural defense mechanisms at all, so an elaborate false one was built to obscure the too-sensitive true self. Sadly, many narcissists are so far gone into their narcissism they will never be able to access their true self or even become self-aware enough to realize the TS still exists, even if in an undeveloped, atrophied state that never sees the light of day.

I found several excellent articles about crying in therapy, and what crying actually means (the answers are surprising). Many therapists today, especially behavioral or short-term therapists (which insurance companies prefer because these therapies cost them less to cover), don’t encourage crying because they think it means the patient has been unnecessarily triggered. But in psychodynamic therapy (of which “reparenting” is one form of this), in which patients are encouraged to experience and release emotions and painful incidents from their past, crying is encouraged and usually signals an important breakthrough. Psychodynamic therapy is the type most effective (and most often used) with people with NPD when CBT (a type of behavioral mindfulness training) isn’t used, and it requires a highly empathic therapist who can effectively mirror (reparent) the narcissistic patient (without offering supply) and make it “okay” for them to experience their true emotions, which includes crying their pain out.

But I can’t cry!
This article from Psychology Today, How to Cry in Therapy, gives some tips on how a patient can get the waterworks going. I haven’t tried most of these, but others may find them helpful. These techniques can be used both in and outside therapy.

Two more excellent articles about crying come from The Psychotherapy Networker:
Therapeutic Crying: In Praise of Therapy’s Best Kept Secret. Crying is actually the healing phase that comes following a period of extreme stress (either pleasant or unpleasant), after the stresser has been resolved. The tears, rather than being “sad” or “happy,” actually signal a relaxation and sudden release of tension that follows that. Both tears of grief and tears of joy arise from this sudden release of tension/hypervigilance/fight-or-flight response and a transition to healing (examples would be crying after a close brush with death has passed, a very sick relative finally passes away; or watching your child get married or graduate.) It’s why sometimes being offered kind words or a hug can get the tears flowing.

Up goes the white flag.
Crying can also be a physiological “white flag of surrender”–when you finally acknowledge, even in the midst of a crisis, that you can do nothing more to resolve it, and find yourself dissolving into tears. Its evolutionary purpose is to draw others to you to comfort you. Empathic types are sensitive to these signals and will be the first to offer comfort or help, but highly manipulative people (with cognitive or “cold” empathy) are drawn to this kind of “helpless” crying too, so it’s wise to be vigilant of who comes along to help.

Another article from The Psychotherapy Networker, Why We Cry: A Clinician’s Guide, is another excellent article that explains why crying (especially deep crying) is so beneficial.

Should touching a patient be involved?
According to the comments under these articles, the jury’s out on whether it’s best for therapist to give the patient space and simply offer a box of tissues (some find this gesture condescending though), or if it’s okay for the therapist to actually physically hold or touch the patient. I think whether touch is involved or not depends on the individual and how comfortable they are with physical contact or having that sort of connection with a therapist. In all cases, it’s probably best for the therapist to ask the patient first if it’s okay to give them a hug or pat them on the back or offer any other kind of physical contact, no matter how slight. There’s even a waiver a therapist can have a patient sign to allow “limited touch” which can avoid potential lawsuits for sexual abuse or harassment.

What about when the therapist cries?
Related to the above, it’s surprisingly common for therapists to cry with their patients and it’s not unethical or even considered unprofessional s long as it’s not overdone. In fact, nearly three quarters of therapists have at least “teared up” in a session, sometimes even when the patient isn’t crying! It would seem the most empathic therapists (who were probably drawn to this profession because they’re empaths) would be the most likely to cry with their patients (or go home and cry afterwards, as many do). Many patients prefer their therapists to remain dry eyed because it makes them seem more “in control” as far as the patient is concerned, while others welcome a therapist’s tears because it makes them feel like the therapist “really cares about me.”


17 thoughts on “Crying in therapy: how important is it?

  1. LOL! Performance anxiety? I thought that only happened in sex. I remember a Wiccan ceremony I was in for Samhein ( Halloween). It was a very large group of women led by Z Budapest. We all had to sit on the floor which was really uncomfortable in such a crowded space. Z told us to think sad thoughts and cry. Everyone cried except me. I just couldn’t connect to sad thoughts while I was physically uncomfortable. The second part of the ritual was a spiral dance which was wild and wonderful! But when I wanted to try Prozac (after reading “Listening to Prozac”), I had no problem summoning crocodile tears.

    I think the value of crying in therapy is what kids happening inside you. The years are just as outer manifestation.

    Hey, remember Annie Hall when Annie had her first therapeutic session and cried? Woody is all impressed and jealous. He said, “I never cry. I whine.” Maybe I’ll see that tonight instead of Alice’s Restaurant as planned. But I just adore that graveyard scene when Joani Mitchell sings “Songs to Aging Children.”

    Liked by 1 person

      1. I did watch it last night. Remember when he is out with Shelly Duval and he says there is too much emphasis on the orgasm to replace missing parts of our lives and she says, “Who said that?” And he answers, “Leopold and Loeb.”

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  2. My brother recently committed suicide and I still haven’t cried for him. It’s been months and I’m just numb and in shock. I haven’t cried in therapy (or out of therapy). I don’t know why but it really bothers me. I don’t know if it’s my meds or not. I feel so guilty! 😦

    Liked by 1 person

    1. Joyce, I’m so sorry to hear about your brother’s suicide. 😦 I never knew.
      Maybe writing in a journal about it might help with the numbness and shock, which is normal for awhile after a tragic event like that. Don’t feel guilty; it’s a self protective mechanism and eventually the grief should begin to break through. Do you see a therapist about this? Talking about it might help…or writing about it.
      Big hugs.


      1. I do see a counsellor and she says not to feel guilty but it’s been since July 26th and I’m still numb. She says its probably not my meds, that it’s the situation. But if it is my meds, I’d like to lower the dosage or go off them. I hate feeling numb. The last time I remember crying is this time two years ago, over some little thing. And I can’t even cry over this? It doesn’t make sense to me. Thanks for listening.

        Liked by 1 person

  3. Thanks for this. I am one of those people that finds it almost impossible to cry in therapy. I just get enormously anxious and dissociate instead. I would much rather cry, I feel like it would release a lot of stuck emotion, but it just won’t happen for me. Good to know I’m not the only one.

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    1. I don’t know what to tell you, because I’ve never cried in therapy either. Right now I don’t have a therapist but I think if I get one, I might be able to cry now, MAYBE. It would depend on the therapist.
      You could try some of the suggestions in the linked article and see if it helps. Are you able to cry alone? I worked on this until I was able to. Music helps a lot because it’s a “safe” way to trigger strong emotions, then I “connect’ that emotion to something bothering me or something that got triggered. Knowing no one will see me helps too.
      I just need to learn to transfer that into a therapy setting. But at least it’s something. I always feel great after having a good long deep cry.

      Liked by 1 person

  4. I cry in my sessions, which is unheard of. I was trained, brutally, by my ex that crying was emotionally manipulative. My therapist is teaching me that it’s healing. She gives me space, a box of tissues, and i can see that she gets upset for me or angry, although she herself doesn’t cry. I am learning that crying can help, and it stops me from spiralling into the terror of depression. I really enjoyed this article, it’s really informative, and I’ll be sure to read the links you posted x

    Liked by 1 person

    1. The therapist who helped me eons ago behaved in a similar manner which I thought was appropriate and really appreciated under the circumstances. I’d also like to thank Otter (sorry but I keep forgetting your “real” name) for the enlightening info on the subject. I’ll add that the last time I brought myself in for treatment of depression, I’d come to the realization that I needed help after sitting through the movie “Marley and Me” and noted that I hadn’t cried when the dog died. That’s when I knew that I was really sick.

      Liked by 1 person

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