Uncharted 'tearitory': mapping Australian therapist experiences, attitudes, and understandings of their in-session tears

2017-01-23T23:45:01Z (GMT) by Brownlie, Megan Ruth
This study explored psychotherapist experiences of and attitudes to in-session crying. Historically, therapists were encouraged to hide their emotions from clients. Subsequently, self-disclosure and empathy theory and research developed with a focus on verbal modes of self-disclosure and empathic communication, to the neglect of the non-verbal dimension of these interventions. The current study attempted to locate therapist tearfulness within the theoretical discourses on self-disclosure and empathy, at a time when the shift towards a more relational focus in therapy has encouraged the therapist’s greater use of affective self-disclosure. The data for this study comprised the responses of 439 Australian registered psychologists to measures of therapist crying tendency and attitudes, self-disclosure frequency and attitudes, trait affective and cognitive empathy, and crying in daily life. Comments provided by participants about their experiences of crying as a therapist or of seeing their own therapists cry, and about their views of therapist crying were qualitatively analysed to contextualise the quantitative data. The correlational and regression analyses revealed that participants had a greater tendency to cry if their beliefs about its appropriateness and therapeutic value were positive, they were prone to crying in response to positive emotional events, and they had personal experience of therapist crying as a client. Other factors, more modestly associated with an increased tendency for therapist crying, included greater experience as a therapist, more positive attitudes about self-disclosure, and more frequent use of self-disclosure to reveal personal and affective information to clients. Being cognitive-behavioural in therapeutic approach was associated with a significantly reduced tendency to cry as a therapist. Unexpectedly, gender and levels of affective empathy were unrelated to the tendency to cry in session. Although 61.5% of the sample had experienced therapist crying, it was typically a very mild response. The qualitative analyses revealed that those who had cried were aware of the potential harmful effects it could have for clients and of the necessity for maintaining a client-focus. The appropriateness or therapeutic value (or harm) associated with their crying, however, was seen as context-dependent; it depended primarily on the client’s needs but also on the nature of the therapeutic relationship and the intensity and frequency of the therapist’s crying. The findings point to the importance of the distinction between interpersonal empathy (i.e., how individuals react to others’ emotions) and therapeutic empathy (i.e., how therapists respond to clients’ emotional content). Of further significance to understanding therapist crying is the distinction between crying as a self-oriented emotional response (i.e., related to personal experience and distress) and crying as an other-oriented emotional response (i.e., triggered by the witnessing of others’ emotions). Therapist crying was typically other-oriented and often associated with positive relational emotion (e.g., feelings of care, connection, or empathy). The study concluded that therapist tearfulness needs to be addressed in the professional literature and training curricula if therapists are to learn to use their emotional responses in ways that minimise harm and provide benefit to their clients. Thesis submitted in partial fulfilment of the requirements for the Master of Psychology (Counselling)/Doctor of Philosophy, Faculty of Education, Monash University.