Abstract
Patients’ crying in psychotherapy can, at times, be an indicator of a healing process and reflect patients’ engagement. This study explored the relationships between Israeli patients’ crying in therapy, the working alliance, therapeutic change and attachment styles, using similar procedures to the ones used by Genova et al. (Psychotherapy, 58, 160) in a recent investigation of Italian patients. One hundred and thirteen patients completed an online survey in Hebrew about crying in therapy and self-report measures assessing the working alliance, therapeutic change and attachment styles. Our findings revealed that self-reported working alliance was related to the patients’ perceptions of their therapist responding to their most recent crying episode with support and compassion. Therapeutic change was associated with a tendency to cry in therapy and higher instances of crying in therapy during the last year. Patients with anxious-preoccupied attachment styles had more faith that crying would lead to being understood by their therapist. Dismissive-avoidant attachment style was related to higher likelihood of feeling like the most recent crying episode helped the patient understand things that they did not understand before and feel like their tears expressed things that words could not. Further, fearful-avoidant, anxious-preoccupied and dismissive-avoidant attachment styles were all related to stronger faith in the therapy relationship strengthening after crying. These findings are in line with, and expand on, Genova et al.’s (Psychotherapy, 58, 160) findings regarding the therapy alliance, crying in therapy and attachment styles. Implications for the relationships between patient attachment style, therapy alliance, therapeutic change and crying in therapy are discussed.