Can crying be part of practice?

I'm reading a lovely book about narrative therapy called "Retelling the Stories of Our Lives," by David Denborough. So much of it is surprisingly moving to me: not just the case studies but also how he describes the practice of retelling our stories in order to regain some control over our lives. One particular passage just struck me as I was reading. Dr. Denborough recounted a situation where the client began to sob during a phone call; this display of emotion brought Dr. Denborough to tears. That's all he says about it: his client was overcome with emotion and he was as well. I was both charmed and startled by this anecdote. Charmed because it is the great joy of our work to be deeply moved by our patients; and startled because this is something I think about a lot. Specifically, I often wonder about how much we should share with our clients and when and how we can do it effectively.

Crying with my patients is particularly interesting to me, not least because I just spent the last five years doing hospice work. A supervisor I had in my graduate school internship once told me that it's ok to cry in front of your patients, as long as you aren't crying more than they are. To that end, I'm usually able to maintain a certain amount of distance in emotionally charged visits while also remaining compassionate and open. But once in awhile, someone's story moves me unexpectedly and I feel those little pinpricks behind my eyes that signal the start of tears. Is it ok then if my eyes well up during a visit? Is there a way to be (slightly) tearful and have it be therapeutic for the client? Is there an appropriate amount of tears? Are any tears acceptable?

This is a tricky question for me. I think that part of what draws people to social work and other helping professions is a certain amount of sensitivity to others. In fact, we need to be sensitive and vulnerable with our patients in order to allow them to be vulnerable with us. However, we also have to protect our clients and ourselves. We cannot cry at every sad story; if that's happening, it's a bright red flag of compassion fatigue. At the same time, we are only human. There will be moments when we feel overwhelmed with emotions. My question is, what do we do at those times?

As with most things, there are lots of variables. Regarding Dr. Denborough's example, there are two indicators that crying was appropriate in this case. First, this was a client he had a fairly long relationship with; therefore he would have been able to judge how his own feelings would impact his client. In this case, I suspect the client felt validated and touched by his therapist's tears. Second, this took place during a phone call. Not being in the same physical place is a good thing here, so that the therapist could be discreet about his reaction if the client was startled or upset by it.

I'm always interested to hear about how other people handle this. When I worked in hospice, my own rule of thumb was to take a deep breath when I felt those pinpricks and examine my reaction later. I suspect the same rule will apply in my new role. But I reserve no judgment for practitioners that allow a little tear here and there. Tell me, is crying ever a part of your practice?