Crying in Psychotherapy: Catalyst, Byproduct, or Resistance? A Qualitative Exploration of Therapists’ Working Models Across Theoretical Orientations

The experience, expression, and exploration of emotions are central to the psychotherapeutic process, and crying is a frequent part of it. Yet, its role remains surprisingly under-researched. In the absence of established theories or guidelines on adult crying in psychotherapy, therapists rely on their own working models - likely shaped by factors such as clinical experience, specific training, and personal beliefs. This study explores therapists’ assumptions about crying in therapy, its perceived roles and functions within the therapeutic process, and the interventions used in response. We conducted a total of N = 33 interviews with therapists from psychodynamic, cognitive-behavioral, and systemic orientations. Data were analyzed using an iterative qualitative approach based on the principles of Grounded Theory. From this, we developed a consensual, integrative category system that synthesizes therapists’ diverse working models and highlights their shared foundation across orientations. This cross-orientation framework captures common assumptions and strategies while also accommodating orientation-specific nuances. Findings indicate that therapists commonly view crying as a marker of pivotal therapeutic moments, often emphasizing its role in relationship building. At the same time, they distinguish between different forms of crying, with varying assessments of whether it supports the process or signals resistance and avoidance. The resulting integrative category system provides a conceptual basis for future research and theory development on crying in psychotherapy.