Shedding Tears in Video Sessions

Why Have Our Clients Stopped Crying?

Maggie Mulqueen

There are two essential ingredients in any therapist’s office: a place to sit and a box of tissues. The tissue boxes are our profession’s silent form of permission that crying is allowed—even encouraged—in therapy. We place them with intention, so that they’re visible and within clients’ reach. Running out of tissues is akin to running out of food at a dinner party. It might not stop the conversation, but its absence is noted.

I have four tissue boxes in my office: one in the waiting room, one at each end of the couch that my clients use, and one next to my own chair. Despite this plethora of options, I often have to motion to clients that the tissues are there for them. I do this because offering tissues is a form of comfort. As they wipe their eyes, some ruing their decision to wear mascara, they’re experiencing—in a small but significant way—that I care. Some clients will even enter my office, pick up a box, and put it in their lap as they sit down: a clear indication that it’s going to be a tough session.

I’m not a therapist who judges the value of a session by the presence or absence of tears. But, now that we’re a few months into the pandemic and meeting remotely, I’ve realized that, despite being in the midst of what may be the most uncertain time in their lives, my clients are hardly crying at all. Furthermore, any crying that’s happening over screens these days isn’t nearly as intense or spontaneous as it was when we were together in my office.

No Crying on Camera

Ironically, our computer cameras are often bringing our faces much closer than they ever were person. But even with this new form of intimacy, my clients’ tense expressions rarely soften into tears. Although many still thank me for our remote sessions and say they feel better afterward, the lack of crying has me privately questioning how much work is actually getting done.

My concern is heightened because the pandemic has ushered in so much more loss for my clients. Just since we’ve been asked to shelter at home, one client’s grandmother has died, another’s wedding has been cancelled, a baby’s been born without the support of family, a college career has ended without a graduation, and a spouse hasn’t been able visit her partner in the hospital. If we were discussing these kinds of traumas during in-person sessions, I’d expect to be restocking my tissues frequently.

Clients still bite their lips or choke back tears as they share these new realities with me, but when I’ve suggested they go ahead and allow themselves to cry, I’m met with uncharacteristic resistance. They’ll shake their heads or tell me they just can’t. 

Is this resistance a function of the efficacy of meeting remotely? Does our presence on a screen, rather than across a room, leave clients feeling more alone, or is it just my experience? Are my skills not translating across this new medium, thereby keeping the work from going as deep as it had before?

I’ve always held my clients, metaphorically speaking, in various ways during our sessions. I might mirror their breathing or lean closer to convey how important their words are. Even if I could mimic these moves from my home computer these days, some of my clients are speaking with me while walking, sitting in their car, or hiding down in their basement, trying to fashion a sense of privacy for themselves. Whatever their circumstance, the subtle nonverbal comfort available to us in person is harder to establish.

It’s Okay to Cry—Or Not

I’m coming to accept that I need to do what I so often admonish my clients for not doing—using my words. When I notice people holding back tears, I’ll now ask if they feel comfortable allowing themselves to cry at that moment. I’ve started suggesting they bring tissues to our sessions, “just in case.” We talk about how they might allow space for their feelings to be more present. Sometimes I even try to support them by lightening the mood with Simone de Beauvoir’s delightful quip, “No matter how many tears you shed, in the end you always blow your nose.”

But perhaps I’m asking too much. Perhaps holding steady these days is the best we can all hope for. I have no experience living through a pandemic, and regulating my own feelings has been challenging at times. I also know that many people find it difficult—even scary—to cry by themselves. It’s the understandable fear of falling down an emotional black hole with no one to pull you back up.

Most of us are holding our breath while we wait for the pandemic to end. But with no end in sight, we keep our guard up. That makes it hard to cry. Crying is a release. It’s vulnerability in action. And perhaps it will remain out of reach until that long-awaited day when we can be in each other’s presence again, and finally pass the tissues in person.

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Maggie Mulqueen, PhD, is in private practice in Brookline, MA. She’s the author of On Our Own Terms: Redefining Competence and Femininity. 

Photo © iStock/joedebiase

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Topic: Anxiety/Depression | Professional Development

Tags: 2020 | Anxiety | crying | Cultural, Social & Racial Issues | empathic communication | empathy | Illness | Illnesses | online | online therapist | online therapy | sadness | stress | stress anxiety | therapeutic crying

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3 Comments

Tuesday, May 12, 2020 6:20:18 PM | posted by Lesley Vlietstra
I found this article interesting because I have never cried during a therapy session. Not crying is part of my problem. But during the first two virtual sessions after lockdown, we were unable to get the camera to work so we interacted by voice only. I found, to my amazement, that I was able to speak about deep, previously unidentified issues, and tears came. I was glad that my therapist couldn’t see me. I am convinced that it was only the blank screen between us that allowed me to feel and speak about those things.

Monday, May 11, 2020 12:43:01 PM | posted by Sam Dearing
I saw two therapists for a total of 6 years. I never once cried. The first woman tried to make me cry and would mock and humiliate me when I didn't. Crying is over-rated in my opinion.

Friday, May 8, 2020 1:46:11 PM | posted by Donna Lennon
It’s an interesting question. I know new therapists sometimes rate the quality of their session on whether a client was tearful or not. I’m interested in your observation as I have a client who I was meeting face to face. She has been abusing substances and one of her goals was to allow herself to feel her feelings instead of suppressing them with alcohol, for example. She has some months of sobriety now and we are meeting via telehealth due to the corona virus. She makes statements like, “now that I’m ready to deal with this, we’re communicating over computers. There’s no chance of me taking that risk now.” She is now sharing some feelings but not in an intimate or vulnerable way. I’d love to know if other therapists are encountering this response and how to intervene. Also of interest, I have other clients who seem to be sharing at a deeper level since we are meeting via telehealth. Perhaps feeling safe with the distancing or from being at home? Thanks for your timely article.