Why We Don’t Pass the Tissue in Psychotherapy (And No, It Is Not Because We Are Mean)

Psychotherapists are taught not to hand out tissues when someone is crying.

I always find myself cringing when a therapist is shown handing a tissue to a client in films or on television. Real life therapy, however, is a little less Hollywood and a little more nuanced.

In training, us psychotherapists are taught not to hand out tissues when someone is crying. Why? Because therapy is not about tidying up emotions like spilled tea or wiping away tears like a polite guest at a funeral. It is about holding space for feelings and letting clients experience them fully on their own terms.

Passing the tissue can unintentionally send the message; don’t feel and move on. That is the last thing the client needs. Often the tearful moments are not just moments of sadness but signals of something deeper, grief, relief, anger or breakthrough. By rushing to fix the emotion, the therapist might close down the very experience the client needs to process.

There is also an unspoken rule of therapy: emotional self-reliance. Clients come to learn how to sit with discomfort and find their own resilience. If the therapist is always the one offering comfort through tissues or soothing words, the client might miss out on building that vital skill.

Of course, therapists are human. We do have tissues on hand, strategically placed. But we wait until the client reaches for one first. It is a small gesture loaded with respect and trust, teaching self-soothing as a way of creating and strengthening independence.

Beyond offering tissues, therapists support clients in cultivating independence by fostering self-awareness, encouraging adaptive coping strategies and building a strong therapeutic alliance. Rather than providing ready-made answers, therapists guide clients toward discovering their own solutions, challenging unhelpful thought patterns, and developing a deeper sense of personal agency.

In psychotherapy, we explore diversity of experience with empathy and without judgement.

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