In Therapy

A user's guide to psychotherapy

How to Cry in Therapy

Mailbag: Bawling in Therapy

Little bitty tear won't let you down
I like the mailbag. You give me the topic and I pontificate for 1000 words. Today we have another disguised and distorted letter from an unidentifiable and possibly fictional reader:

I would love to hear about how to just let go and be able to cry in therapy without inhibition! That would be a great blog!

Before diving in we need to pause for a moment. This question implies two things:

  1. crying is desirable, and 
  2. for some people, it doesn't come easily

Is crying desirable? Why would we want to cry in therapy? Or anywhere for that matter? It's messy, we make funny faces and it usually means we're in touch with some degree of pain, loss or frustration (could be tears of joy, but I don't think that's what Fictional Reader is talking about). Many people feel they're at their most vulnerable when they're crying. So why cry?

Find a Therapist

Search for a mental health professional near you.

Crying is all those things, but it's also a great tension release, it can lead to deeper insight and it's an intimate moment that can form a bond between two people. Some also believe deep expressions of emotion lead to lasting changes for the better. More on that later.

Now to crying doesn't come easily. Some people are reading this line and shaking their heads in disbelief. Some are also wiping their eyes because reading that made them cry. Access to emotion spans the spectrum, from those who cry at the drop of a hat (a very sad, hurt hat) to those who haven't felt a tear since the Carter administration. And a bunch of people in between who cry a major life events and some McDonald's commercials.

A group within this spectrum truly want to cry but cannot. Or maybe they can cry when they're alone, but not with other people. Or just not in therapy. The emotion is there, the desire is there, but they're blocked. They're emotionally constipated.

I should take a moment to point out that not everyone believes crying helps. Therapists have different opinions on emotional expression that vary from "it's problem to be solved" to "it's a distraction" to "it's a powerful path to healing." As a psychodynamic therapist, I believe that most of the time emotions are essential on the path to healing. The research is mixed. A recent study took a look at the crying habits of 1000 women and found that only 1/3rd experienced an improvement in mood after shedding a few. Interestingly, the more intense the cry, the greater the benefit, which may actually support the validity of a good, deep cry in therapy. Some theorists believe crying is evolutionarily designed to strengthen interpersonal relationships. Others point to the physical benefits

How to cry is an interesting developmental concept, really. We don't teach newborns how to cry, they're experts from the start. We give a lot of soothing, shushing and "quiet down!" during childhood to contain emotional behaviors so they can function within the social system. Perhaps some learn how to do this so well they can't cry even if they want to. They're so used to putting on the brakes they've forgotten how to let go.

Back to the question. The client is the boss, and if the client wants to "cry without inhibition," let's find the Tin Man's oil can and turn on the water works. What might help someone bawl on the couch?

Explore Blockage: Inhibition is "a feeling that makes one self-conscious and unable to act in a relaxed and natural way." Perhaps something is scary about shedding tears, and this makes it hard to let your guard down. What inhibits your tears? Is it a message like "big boys don't cry" or "emotion is weakness" to "if you cry, they win?" Did something bad happen when you cried in front of someone? What do you imagine might happen if you cry? Will you go crazy? Will the therapist think less of you, or feel overwhelmed? What would you gain by crying? And what have you gained by not crying? This is all prime material to discuss in a therapy session.

Systematic Desensitization: If what we're talking about is a fear, a fear of crying or being seen crying, maybe we can borrow the best technique our behaviorist friends have to offer -- systematic desensitization. This involves gradual exposure to the fear-producing stimuli paired with relaxation. Imagine crying. Relax. Imagine crying in front of your therapist. Relax. Imagine crying and look at a photo of your therapist. Cry outside your therapist's office. Cry listening to her voicemail. Cry in her waiting room, then step into the session continuing the water works. I don't know, it might work. Whatever happens, give the credit or blame to Pavlov.

Meta: I've worked with people who wanted to cry but couldn't, and we'll explore how it feels to not be able to cry in session. As we discuss their exasperation at being shut off from their emotions, it's not uncommon to see our talk follow a roadmap like this: anger, frustration, sadness and then tears. They find themselves crying about not being able to cry. Ironic, eh?

Act: Not a tool I've used, but I've heard it can be effective. Some people can act out the crying behavior (looking down, body heaviness, scrunched face, groaning, etc.) and the feelings will follow. Some would say this is faking it, others would say you're leading with your body and letting your emotions catch up. They say forcing a smile makes you feel happier, so forced crying behavior may tip you into a full-fledged crying jag. Probably something to discuss with your therapist before diving in, BTW.

Shut Up: Sometimes the solution is as simple as this. When you're talking, you're in your head, finding words, forming sentences, maintaining a coherent conversation. People often describe their feelings as rumbling up from a place deep in their body that defies words. Stop talking, turn down the volume of your thoughts and pay attention to your body and see what happens.

Quit Trying: For many, the point of therapy is to be yourself in the moment. If you're really unable to cry at this time, why not accept this? That's where you are right now, why waste energy focusing on what you should be doing? It's possible this whole task is just giving you another problem to beat yourself up about: I'm a flawed person because I can't cry in therapy. Maybe it would be best to drop the shame and look at what you do feel instead of what you don't.

If you're still determined to cry in therapy, and all else fails, just watch this in the waiting room two minutes before session time. Holy cow. 

--------------

You're free to cry as my facebook friend or as a visitor to my website. I'll even provide the Kleenex.

Ryan Howes, Ph.D., is a clinical psychologist, writer, musician and professor at Fuller Graduate School of Psychology in Pasadena, California.

more...

Subscribe to In Therapy

Current Issue

Love & Lust

Who says marriage is where desire goes to die?