Some time ago, in clinical practice, I served a number of cry-prone clients. Crying in therapy is not uncommon, and it has to do with the emotional implications of the contents and memories you are working on. But other patients showed more resistance to crying ; these cases can be a challenge for many therapists.
What happens when a patient is resistant to crying and does not cry?
Crying is an emotional and physical expression at a cerebral level , related to a great amount of neurotransmitters and hormones that have a relaxation function.
Within the psychological community there is a saying that “If a patient cries, he is getting cured”, and from some psychological currents, this may have some truthfulness. But when a patient is resistant to crying many therapists make the mistake of digging deep into the patient’s life to release their suffering through crying. This is counterproductive, since insisting that the patient must cry could cause conflict in the therapeutic relationship , since our objective as psychologists is not that the patient “cries”, but that he solves the conflict that he presents us with, although crying is one more part of the way to the solution of that objective, in some cases.
The recommendation is to let the patients carry on with their rhythm and the therapeutic link is built block by block. Working on patience and unconditional acceptance is a good key to successful treatment in these patients.
The resistant patient cries in session. What does it mean?
Here are some of the implications of a patient crying in therapy.
1. Acceptance of suffering
Many of the patients who come to the practice are in deep denial of their conflicts, both internal and external, and are reluctant to remove their blindfolds. When the patient succeeds in adopting a new approach, this can be an explosion of new emotions and behaviours that could terrify them. At this point it will all depend on the therapist and his methodology of work.
2. Therapist’s acceptance
Some patients go through several sessions without deepening their conflicts, as they seem to test the therapist’s ethics. It is normal that at the beginning of therapy they may not have enough confidence to show their weaker and more fragile side; therefore, when the patient surrenders to tears, this is a sign of confidence and is positive in creating a strong therapeutic bond.
3. Possible depression or associated diagnoses
In some cases there are patients who are “Atypical”, because they show depressive symptoms but there is no sadness, crying, etc. We would be facing an atypical case and not a conventional resistance to crying. It is important to evaluate in depth in order to rule out a diagnosis of some psychic disorder. In these cases the ideal is to refer to a clinical specialist or to the psychiatric area if the case is serious.
4. Breaking down beliefs
As a short anecdote, I had the experience of treating several patients who were reluctant to cry because among their beliefs were some like: “crying is a woman’s thing”, “crying is a sign of weakness” and in the worst case “crying is a homosexual’s thing”.
In the practice it is common to find this type of patient who has grown up in a macho culture , therefore you must work on patience and work with “tweezers” those beliefs. When these beliefs begin to become dubious and unadaptive to psychic health, then it is likely that the tears will begin to flow.
A sign that the therapist is doing well
When patients surrender to crying after so much psychotherapeutic work, it is certainly a good sign. In these cases, the therapist is on the right track. Keeping up with the patients’ pace of change is by no means an easy job; it is hard and tiring, but rewarding. Taking care of emotional health is essential.