Is it OK for Therapists to Cry (with Patients)?

No. That was easy. Here’s why:

• It blurs the line of the doctor-patient relationship, potentially putting the patient in a very awkward position. Does patient now need to comfort therapist? Of course not, but the patient might not be able to discern that, especially in their emotional turmoil, and this is a question they will inevitably be asking themselves.

• Not crying during a distressing session is a demonstration to the patient that intense emotions can be managed and tolerated without becoming overruled by them.

• For the sake of the therapist, it is not healthy to be getting caught up in patient’s problems on a regular basis.

• It de-stabilises a therapeutic alliance. If doctor is emotionally shaken at one declaration by patient, patient might be more reluctant to share other information, whether they are uncomfortable with doctor’s crying or because they don’t want to upset doctor.

An exception occurs when the therapist makes an effort to not become emotionally caught up with the patient, but is physically unable to prevent tears (however, if this happens frequently, I would say there is an issue with the therapist). Crying is like sneezing; you might not be able to stop it (sometimes you can), but you can at least minimise its display. I myself have been deeply, and sadly, moved by some patient’s stories, and I have cried. But I did not cry in the presence of that person, because it was not about me, it was about them.