Thursday, 14 July 2011

Tissues and Tears: The controversy of Lacrimation

According to Wikipedia, tears are "the secretions of the glands that clean and lubricate the eyes.  Strong emotions, such as sorrow, or elation, along with irritation of eye, may lead to an increased production of tears, or crying."

Furthermore, in nearly all cultures, crying is seen as a specific act associated with tears trickling down the cheeks and accompanied by characteristic sobbing sounds. Emotional triggers are most often sadness and grief, but crying can also be triggered by anger, happiness, fear, laughter or humour, frustration, remorse, or other strong, intense emotions. 

"The soul would have no rainbow had the eyes no tears."  John Vance Cheney

Tears from the therapist's chair are somewhat of a controversial issue.  According to traditional theory a therapist should be empathic but neutral, but as a general rule she should not disclose her feelings.  Neutrality serves the purpose of establishing the patient’s independence and self-determination, a boundary that underscores the separateness, so in this sense it is therapeutic.  From this stance crying is not ok, being both a breach of neutrality and an act of self-disclosure.

Relational theory has progressed a little further, valuing both empathy and connection above all and taking a rather more permissive stance towards a modicum of self-disclosure, crying is considered ok as long as it favours attachment and communicates the therapist’s attunement (as opposed to neediness or a manifestation of a lack of control).

I have noticed that there are many forums where clients share their stories of crying therapists but – judging from the paucity of literature – it seems that therapists themselves are reluctant to tackle the subject of our own tears.  I wonder why?

According to Judith Kay Nelson, author of 'Seeing Through Tears', about two thirds of therapists have on (rare or isolated) occasion been moved to tears in front of their clients, and half of the remaining third is moved in session to the point of wanting to cry, but they actively suppress their tears.  For most therapists who cry, tears are usually an isolated episode.

I've found myself shed more than a single tear in the presence of clients.  I do not, nor would I, sit there blubbing, nor do I reach for a tissue, but I might find myself drying the corner of my eye.  I would be worried if I did not feel the emotions that prompt me to well up from time to time, given the material I am so often a witness to. 

"Every tear should live its purpose.  Don't ever wipe the reason away."  Jessica Simpson

In my experience, my tears are usually a timely acknowledgment of something (usually historical) that a client has shared with me, which they may struggle to connect with, beyond words or which they may, with time, have either become less connected with or so identified with that it no longer carries the emotional response it once did, or perhaps still could.  In either scenario, the appearance of my tear(s) is both powerful, and significant, for me as a therapist, and for our work together. 

Clearly, sobbing uncontrollably is rarely, if ever, appropriate.  Most experienced therapists, especially those among us who have been in therapy themselves, have grown to become comfortable with painful places most would rather avoid and, as a result, are well equipped to embody a state of compassion and to not feel overwhelmed or triggered by their clients' issues.

It is, I believe, my job to guide individuals through their own therapeutic process.  I am adept at doing this, by virtue of my training, and the fact that I have been in therapy myself.  I do not and would not expect a client to anything I have not done, or would not be prepared to do. 

My tears are a sign of empathy which I believe to be a normal, healthy and sincere element of the complex human process of relating emotionally to the experience of another.  Receiving empathy can help us feel safe and understood, strengthening and later maintaining the bond of trust between therapist and client. 

Sometimes one of the explicit goals of therapy is for a client to become comfortable with their more vulnerable feelings.  And often, a therapist transparently displaying empathy for a client helps that client foster self-compassion.  I say 'often' because for some, the experience can instead feel rather challenging, and possibly uncomfortable. 

Should my emotional expression ever contribute to a client feeling uncomfortable, I sincerely hope we would have an opportunity to explore this.  It is often the discomfort experienced in the room that is the 'nugget' to be worked with.  People can feel uncomfortable with vulnerability, and struggle to receive empathy.  Perhaps an expression of my emotion risks disappointment: crushing the idea that, as a therapist, I am perhaps superhuman and detached...

I am a therapist with a heart, and more often than not, I bring it in to the room with me.  It serves me, and it serves my clients.  Rarely do I feel the need to cry, but if and when I do, I do so with good reason, and to suppress or hide my tears would be inauthentic, and incongruent. 

"Let your tears come.  Let them water your soul."  Eileen Mayhew


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