Patient Crying in Psychotherapy: Who Cries and Why?

Capps, Kristen L.; Fiori, Katherine L.; Mullin, Anthony S. J.; Hilsenroth, Mark J.

doi:10.1002/cpp.1879

Cited by 17 publications

(64 citation statements)

References 57 publications

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“…In contrast, patients' emotional experiences are commonly explained in terms of external factors (e.g., life stress), attributed to the disorder itself (e.g., the impact of starvation on emotions in the eating disorders), or seen as reactions to events in therapy (e.g., termination of treatment). An example is the study of patient characteristics and process experiences as to when they cry during sessions (Capps, Mullin, & Hilsenroth, 2013). It is not yet known whether patients and therapists will agree about the emotions that therapists experience in treatment, or which is the more clinically important perspective.…”

Section: Discussionmentioning

confidence: 99%

Patients’ experiences of clinicians’ crying during psychotherapy for eating disorders.

Tritt¹,

Kelly²,

Waller³

2015

Psychotherapy

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Many psychotherapists cry in therapy sessions. Those clinicians who do cry see it as likely to have a positive impact on the therapy or to have no impact, and therapist personality characteristics have not shown reliable associations to crying in therapy. However, it is not known how patients experience therapists' crying, or whether the patient's view of the therapist's characteristics is related to that experience. This study used an online survey, recruiting 202 patients with eating disorders, 188 of whom had received therapy for an eating disorder, and 105 of whom had experienced a therapist crying. Retrospective data from those 105 individuals indicated that therapists' crying tended to be seen positively, but that perception was influenced by the patients' perceptions of the demeanor of their therapist and their understanding of the meaning of the crying. While they need to be extended to other disorders, these findings suggest that therapists' crying needs to be understood in the context of the therapist's perceived characteristics and demeanor, rather than being assumed by therapists to be positive or to have no impact on the therapy.Keywords: Psychotherapy; therapist; patient; crying IMPACT OF CLINICIANS' CRYING 3 Patients' Experiences of Clinicians' Crying during Psychotherapy for Eating DisordersPsychotherapy has a tradition of focusing on the inner world of the patient. However, the inner world of the therapist is also important, as it interacts with that of the patient. Such interaction appears in many forms in the literature, including constructs such as transference/countertransference and the therapeutic alliance. Therefore, regardless of therapeutic orientation, it is important to consider the therapist's reactions to the client during the session (e.g., Gelso & Hayes, 2007;Gilbert & Leahy, 2007;Summers & Barber, 2010).This study addresses one specific reaction -the therapist crying in the session, and the impact of that experience on the patient.Emotional experience in the therapy session and how it can disrupt therapy if unattended are key elements of therapists' reactions. This concept is not limited to the psychodynamic construct of countertransference. For example, Waller (2009) has hypothesised that cognitive-behavioral therapists who experience higher levels of anxiety are less likely to implement core behavioral techniques, making them less effective.Following a series of small-scale reports in the literature, Blume-Marcovici, Stolberg and Khademi (2013) surveyed a large number of psychologists and trainees (N = 684) regarding one specific emotional marker -the therapist crying in therapy. In this relatively diverse group of clinicians, using a variety of therapeutic approaches with a wide range of patients, they reported that over 70% of the therapists reported ever having cried in therapy (with 30% having done so in the past four weeks). Pope, Tabachnick and Keith-Spiegel (1987) found a slightly lower lifetime rate for therapists' crying (56.5%), but these findings represent a ...

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Section: Discussionmentioning

confidence: 99%

Patients’ experiences of clinicians’ crying during psychotherapy for eating disorders.

Tritt¹,

Kelly²,

Waller³

2015

Psychotherapy

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“…Also according to the biosocial theory of Linehan (1993), emotion dysregulation in BPD comprises increased sensitivity to emotional stimuli, unusually strong emotional reactions, a relatively frequent occurrence of complex emotions (more than one emotion simultaneously), and problems in identifying emotions. This author even poses that emotional instability is at the basis of the development of this disorder and that BPD patients' emotional instability may indicate a more expansive style of affective expression (see also Capps et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Until now, little is known about the crying behavior of BPD patients. To the best of our knowledge, only Capps et al (2015) investigated crying specifically in interactions between patients and therapists in small samples of PD patients. However, their Cluster B group was small (N = 18), the level of psychopathology was mild to moderate, there was no specific focus on BPD patients, and they did not address their more general and everyday crying behavior.…”

Section: Introductionmentioning

confidence: 99%

Crying in borderline personality disorder patients

Peter

Arntz

Klimstra

et al. 2019

Psychiatry Research

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Emotion dysregulation and hyperreactivity are considered central features of Borderline Personality Disorder (BPD). We assumed that such emotion dysregulation is also reflected in increased crying behavior of these patients and, consequently, hypothesized that BPD patients (N = 62), compared to Cluster C personality disorder patients (Cluster C-PD; N = 25) and non-patients (N = 54), would show higher scores on crying measures. To evaluate crying behavior, we used a set of specially designed tools. Compared to non-patients, BPD patients showed the anticipated higher crying frequency despite a similar crying proneness and ways of dealing with tears. They also reported less awareness of the influence of crying on others. However, Cluster C-PD patients showed a very similar pattern of findings. Overall, our results suggest that the increased crying of BPD patients likely results from environmental factors or the misperception of situations, rather than from stable traits. Remarkable is that the observed discrepancies in crying behavior compared to non-patients seem to be similar for Cluster-C PDs and BPD.

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“…A database containing tearful expressions as stimuli may thus contribute to perception studies, as well as to research on the response dynamics that are already encoded in these materials. Interestingly, only a few studies to date have incorporated dynamic materials, either as part of laboratory research on weeping (Gračanin et al, 2015;Hendriks et al, 2007;Ioannou et al, 2016;Rottenberg et al, 2003;Sharman et al, 2020) or by means of videotaped case studies (Capps et al, 2013). Some of this research has revealed important insights about the intraindividual functions of crying for weepers.…”

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confidence: 99%

PDSTD - The Portsmouth Dynamic Spontaneous Tears Database

Küster¹,

Baker²,

Krumhuber³

2021

Preprint

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The vast majority of research on human emotional tears has relied on posed and static stimulus materials. In this paper, we introduce the Portsmouth Dynamic Spontaneous Tears Database (PDSTD), a free resource comprising video recordings of 24 female encoders depicting a balanced representation of sadness stimuli with and without tears. Encoders watched a neutral film and a self-selected sad film and reported their emotional experience for 9 emotions. Extending this initial validation, we obtained norming data from an independent sample of naïve observers (N = 91, 45 females) who watched videos of the encoders during three time phases (neutral, pre-sadness, sadness), yielding a total of 72 validated recordings. Observers rated the expressions during each phase on 7 discrete emotions, negative and positive valence, arousal, and genuineness. All data were analyzed by means of general linear mixed modelling (GLMM) to account for sources of random variance. Our results confirm the successful elicitation of sadness, and demonstrate the presence of a tear effect, i.e., a substantial increase in perceived sadness for spontaneous dynamic weeping. To our knowledge, the PDSTD is the first database of spontaneously elicited dynamic tears and sadness that is openly available to researchers. The stimuli can be accessed free of charge via OSF from https://osf.io/uyjeg/?view_only=24474ec8d75949ccb9a8243651db0abf.

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Patient Crying in Psychotherapy: Who Cries and Why?

Cited by 17 publications

References 57 publications

Patients’ experiences of clinicians’ crying during psychotherapy for eating disorders.

Patients’ experiences of clinicians’ crying during psychotherapy for eating disorders.

Crying in borderline personality disorder patients

PDSTD - The Portsmouth Dynamic Spontaneous Tears Database

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