I find this on Google Scholar (abstract, article is linked from there). It’s about the clinician not getting distracted by tissues:
A Tissue, A Tissue–We All Fall Down
Anthony Herbert
Journal of Healthcare Communications 1 (3), 19, 2016
Most health professionals would consider it standard practice to offer a patient a tissue if the patient started crying during a consultation. In this context, it can be surprising that are tissue boxes are not always in the rooms of hospitals and clinics where such conversations occur. Some more advanced practitioners in communication will sometimes argue this should not be our sole response to a patient who is crying [1]. At the heart of such a clinical encounter with a patient who is crying is to determine what this means and how best to respond to their crying and distress. A flexible approach is required, and it may be more the intention behind handing a patient a tissue that is more important than whether a tissue is actually given or not.
One of the challenges with having to leave the room to find a box of tissues (if a tissue box is not already in the room) is that it becomes a barrier to you being with present with the patient in their distress. In one sense, it can allow you to escape from the patient’s distress. Alternatively, it can also be tempting to change the topic of the conversation to something lighter (eg speaking about a less intense topic eg medicines) or more technical (eg description of a medical investigation or procedure) and this should be avoided. Allowing the patient to cry, and giving them time to do this, shows the patient you are aware of their level of distress and that “It is okay to cry”.
The article “Between Us: Growing Relational Possibilities in Clinical Supervision” by Marilyn F Downs of the hughly psychodynamic Wellsley Stone Center uses giving a client the tissue box decreases the therapist’s “neutrality.” It’s about the meaning of the therapist’s action, not especially about the assumptions the vlient makes based on that.
Interpreting results to parents of preschool children, Victoria Shea, Preschool issues in autism, 185-198, 1993, can’t be easily viewed online, but the preview shows:
… place a box of facial tissues in the room. Then if the need arises, the professional can hand the box or a tissue to a crying parent, while saying, in effect, "Many parents cry when given …
Countertransference and role-responsiveness, Joseph Sandler, International Review of psycho-analysis 3 (1), 43-47, 1976 (note the year, and also psychoanalytic), describes:
From the beginning she had cried during each session, and I had routinely passed her the box of
tissues whenever she began to cry. Now I did not know why I did this but, having begun the practice, I did not feel inclined
to change it without some good reason. Without knowing why, I had not felt it appropriate to take up her failure to bring
her own tissues or a handkerchief, although with other patients I would have done this. There were many determinants of
her crying, including her mourning for the mother she wanted to kill off, for the father she felt she had to give up, and so on.
It transpired that when she was about two years old and a second child, a brother, had been born, she felt that she had lost
her mother’s attention, and remembered that at about two and a half years of age she was relegated to playing on her own
in the back-yard while her brother was being washed and changed. At this time she had also been sent to a kindergarten,
and she had the memory of being very withdrawn and climbing into the rabbit hutch at the nursery school and cuddling a
white rabbit. She then told me that she had later learned that after a short while at this school she was diagnosed as ‘autistic’
by the school psychologist, and was apparently very regressed and had uncontrollable rages and tantrums. By this point in
her analysis we were able to get at the repetition in the present of her fear of soiling and disgracing herself, and her need
to control her objects as she had to control her sphincters. However, there was clearly something which was an
important unconscious fantasy for her and which had not been elicited. I had the feeling that we were somewhat ‘stuck’ in
the analytic work. One day something rather unusual happened in the analysis. She had begun to cry silently but
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this time I failed to respond, and she suddenly began to upbraid me and criticize me for not passing her the tissues. She
became quite panicky and began to accuse me of being callous and uncaring. I responded by saying that I did not know why
I had not passed her the tissues at that particular point, but if she could go on talking perhaps we could both understand
more about it. What emerged then was material which lent a great deal of specificity to something which we had not been
able to crystallize previously. It became clear that her great need for control and for ‘structures’ in her life was based not on
a fear of soiling herself, but rather on a fear that she would soil or wet herself and
that there would not be
an adult around to clean her up
Published Online:29 Sep 2013https://doi.org/10.12968/prps.2011.1.129.8
Preview:
… You can also set up a ‘sad corner’ with a box of tissues , where children can go when they are feeling out of sorts. This helps them to recognize that crying is ‘okay’, while also making it …
The above are the first several pages’ relevant results for box tissue cry. They don’t support what the OP heard at the conference, some are highly psychoanalytic, which isn’t how most counselors practice in the US these days because there isn’t great empirical support for it, and none has a research-based approach. The best that can be said of some is that they’re single-case studies, while the worst is that they’re simply theory-based opinions. I could easily write an article using an economic or game theory to say that the tissue box represents a transaction related to who’s going to win the counseling session, but you know what? Just have tissues nearby. If the tissue action means something more to somebody, they’ll say so and you can talk about it. (And nobody’s neutral, even a blank-presenting psychoanalyst, and there are plenty of ways to help people without getting tied up in a knot about it.)
There is a world of great stuff here in this thread, and I’m truly appreciative of what folks are posting so far.
More context: I’m operating in a peer group world. I’m not a therapist; most of us aren’t. We aren’t trying to be. There’s a whole level of responsibility and versatility that happens among therapists which we’re not trained for and not trying to imitate. In some of what goes on, we may partner with therapists, but we know who’s a therapist and who isn’t.
There’s no one approach that is right for everybody. However, we have to start from somewhere. For example, I think it’s generally good for people to talk about their grief, and we try to encourage that, maybe gently push a little where it seems helpful. But we know sometimes people need to be quiet and it’s up to them. Still, we’re primarily trying to create an environment for people to be able to talk.
The person who said “tissues = telling them stop” did so at a conference for people trying to get better at giving peer support. They weren’t so much offering an idea or thinking out loud, but, rather, making a coaching point for the benefit of the rest of us, positioning themselves as experienced counsellors. They were in fact some representative of a church and did counseling within the church. As far as I know they wouldn’t be participating in a group as a member, but only as a facilitator and inevitably as some kind of authority figure. I think this makes it all the more important to look into whether their tissue advice is well founded or not.
Especially in a peer group, the meaning of the interaction is a much lower-stakes proposition. I’d recommend just having tissues nearby and not worrying about whether to hand them to someone. If it’s an issue, they’ll say so. If someone’s thrusting tissues or being insistent, the group can talk about that. The point of this group is being in and managing the grief process, not engaging in deep psychological reconstruction.