I've never been able to cry in therapy but I asked my t once what she would do if I were to start crying. She thought about it for a moment and said, "I would let you cry." While that didn't give me any specifics about what exactly she might do or say, it made me feel more comfortable, made me feel like my tears would be welcomed and respected.

This discussion is really making me think, because whenever my patients start crying (I'm a regular old doctor, not in psych), my immediate impulse is to touch them. If I'm sitting on their hospital bed I'll often put a hand on their knee or take their hand, and if we're in outpatient clinic I might lightly touch their hand/knee or briefly hold their elbow/arm or something. (Other things I do when people start crying is make sure to stop taking notes/typing, turn my body toward them as much as I can, sit down if I'm not already sitting. I would bet that my face changes to a more empathetic expression 'cause I can feel my eyes going soft, but that happens unconsciously.)

To the best of my knowledge, this impulse of mine comes not from discomfort with their distress, but from a desire to communicate to them that this distress is okay and welcome here, that I hear/see their suffering, that their pain has an impact on me. I don't know why this would be an inappropriate message for a t to send--can anyone explain?

There's also the issue of consent. Obviously if people flinch away I withdraw immediately, but I don't usually ask for permission. I dunno if it's any different because I'm a regular doctor so I have to touch them anyway (and usually by the time they're crying I have already listened to their heart and looked in their ears and pressed on their belly etc etc, which I always ask permission before doing)... but reading about how so many people don't like to be touched makes me re-think this approach. What say y'all?