Why are emotions intense in psychotherapy

Emotions in therapy: healing and beneficial crying

Occasionally, patients burst into tears during psychotherapy. American psychologists headed by Kristen Capps from Adelphi University (USA) examined which patients tend to cry and for what reasons they cry on the basis of 52 psychotherapy patients who were treated with psychodynamic psychotherapy for various mental illnesses. Ten patients burst into tears during one session. Female patients in particular who suffered from depression, anxiety or a borderline personality disorder, had problems regulating emotions or had been abused in childhood were particularly prone to crying. Crying was triggered by demands in the therapy session that were evoked by certain interventions, such as being asked to express one's feelings or to deal with unpleasant emotions. In addition, reinterpreting established thought patterns and behaviors, reassessing attitudes, and working with desires, fantasies, and early memories brought tears to the patient's eyes. “The working alliance remained stable despite the weeping,” the authors report. According to Capps and colleagues, the study can help make psychotherapists aware that certain interventions can lead to emotional outbursts in certain patients. However, tears in psychotherapy should not be avoided because they have an emotion-regulating effect and could clear the way for behavioral changes. The fact that the patients themselves find this healing and beneficial is made clear by the fact that they do not withdraw their trust in the therapist and continue the therapy. ms

Capps K, Fiori K, Mullin A, Hilsenroth M: Patient crying in psychotherapy. Clinical Psychology and Psychotherapy 2015; 22 (3): 208-20.