When Therapists Cry

Reflections on Therapists’ Tears in Therapy

Amy Blume-Marcovici

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781317375005
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

When Therapists Cry addresses one of the most authentic and singularly human experiences a therapist can have in therapy: crying. While therapist crying in therapy is the explicit focus of this book, it is used as a springboard for understanding the various ways in which therapists' emotions come alive—and become visible—in the therapy room. In depth clinical examples and conceptualizations from expert contributors illustrate what the experience of therapist crying looks and feels like: why therapists cry, how crying impacts the therapist and the treatment, what therapists feel about their tears, and the many ways in which therapists may engage with their own tears in order to facilitate therapeutic progress, ensure appropriate professional conduct, and deepen their clinical work.

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1

THE TRACKS OF OUR TEARS: AN ORIENTATION TO CRYING

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CHAPTER

1

WHY HUMANS WEEP

Lauren M. Bylsma, Asmir Gračanin, and Ad J. J. M. Vingerhoets

The capacity for shedding emotional tears is uniquely human, and this ubiquitous behavior, displayed from cradle to deathbed, is observed in all human societies across time (Provine, 2012; Trimble, 2012; Vingerhoets, 2013). In scientific terms, emotional crying is defined as the shedding of tears from the lacrimal apparatus in the absence of irritation of the eyes, often accompanied by facial muscle alterations, vocalizations, and sobbing (Patel, 1993). In one of the earliest known written accounts on tears, the ancient Roman poet Ovid (43 b.c.–a.d. 17) was known to have said, “It is some relief to weep; grief is satisfied and carried off by tears.” Ovid additionally recommended lovers to show their tears to their beloved to convince them of the sincerity of their love, suggesting that tears can serve an important social function as well. It seems as if this poet was ahead of his time with respect to his understanding of the functions of tears. Although we all have experience with crying and scholars have speculated on its role throughout history, the specific functions of human emotional tears remain quite elusive. Recent theoretical developments and empirical findings allow us to reach some initial understanding of this, until now, poorly understood human behavior.

In the present chapter, we provide an overview of what is currently known about human emotional crying. We begin with evolutionary and developmental considerations. Next, we consider antecedents of adult crying and how they differ across individuals. This is followed by a discussion of the main functions of tears and empirical findings on their intraindividual and interindividual effects. We also consider the relationship of crying with mental and physical health. We conclude by describing the limited available research on crying in the therapy context, which will set the stage for the remainder of this volume focused on (therapists’) tears in therapy.¹

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EVOLUTIONARY ORIGINS OF HUMAN EMOTIONAL CRYING

While many are familiar with Charles Darwin and his theory of evolution, it is less known that he also discussed human tears in his seminal work, The Expression of the Emotions in Man and Animals (1872). Darwin observed a connection between emotional tears and suffering, as well as between tears and tender feelings, and briefly addressed questions such as whether animals weep, developmental and cross-cultural aspects of crying, and frequent crying as a characteristic of melancholia. Disappointingly, however, he did not speculate on the potential evolutionary function of emotional tears. More recent theories have proposed that human emotional crying has its evolutionary origins in the acoustical signals mammals display when separated from their mother (Hasson, 2009; Murube, 2009; Provine, 2012; Trimble, 2012; Vingerhoets, 2013; Walter, 2006), as the use of such signals is a characteristic and critical feature of all mammal and most bird offspring (Newman, 2007). However, in animals and human newborns, this is a pure acoustical signal (i.e., human infants do not produce emotional tears in the first weeks of their lives), with only humans shedding emotional tears. Further, humans show tears throughout their lifespan, while most other species exhibit their comparable distress vocalizations mainly as young offspring.

DEVELOPMENTAL ASPECTS

Crying undergoes several important changes throughout the lifespan (Rottenberg & Vingerhoets, 2012; Zeifman, 2001). For example, crying tends to decrease in frequency from infancy until adolescence, and there is an increase in the significance of visual tears and a decrease in vocalizations (Provine, 2012). We also observe developmental changes in the antecedents of crying (Vingerhoets, 2013), as well as the development of gender differences (Jellesma & Vingerhoets, 2012).

Regarding the developmental changes in visual tears and vocalizations, we must look to humans’ unique extended childhood, which allows the immature brain to freely and optimally develop. However, this extended childhood also makes human children vulnerable, requiring care, love, and protection from others well into the lifespan (Kipp, 1991/2008). Acoustical crying (i.e., vocalizations), as an attachment behavior, satisfies these needs by maintaining the proximity of the parent (i.e., crying as the “acoustical umbilical cord”: Ostwald, 1972) and by soliciting care and assistance (Bowlby, 1980). This attachment function of crying is thought to continue throughout the lifespan, but shifts from vocalizations to tearful crying. A recent finding that adult tears have a stronger impact on observers than those of infants (Zeifman & Brown, 2011) supports the notion that tears replace the acoustical crying of infants over time. A significant advantage of tears over vocalizations comes from their capability to be targeted to individuals in close interactions, without notifying unwanted listeners of one’s weakness or helplessness. Thus, as soon as an infant has acquired the motoric skills to move independently, we begin to see increases in visual tears.

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The developmental changes in the reasons why humans cry appear to be, at least partially, related to other ongoing normal developmental processes (Zeifman, 2001). For example, the phenomenon of stranger anxiety—whereby infants cry when exposed to strangers—peaks toward the end of the first year. As children age, with the development of feelings of guilt, remorse, empathy, and the ability to take another’s perspective (“theory of mind”), children may also cry, not only due to egocentric reasons, but because they can imagine and sympathize with the suffering of others. From infancy until adolescence, physical pain and discomfort are very important triggers of tears, but for adults and the elderly, these no longer play a significant role. On the other hand, feelings of loss and powerlessness remain important for crying at all ages. In addition, older adults show a greater tendency to cry due to positive situations, particularly in conjunction with experiences that give their lives depth and meaning, such as the intensification of relationships, altruism, and self-sacrifice (Cova & Deonna, 2013; Denckla, Fiori, & Vingerhoets, 2014; Rottenberg & Vingerhoets, 2012; Vingerhoets, 2013). The development of crying over the lifespan can thus be understood as starting from solely egocentric reasons (e.g., physical discomfort) and expanding over time to include societal (e.g., sentimental or moral) reasons. Along these lines, Vingerhoets (2013) outlines five types of emotional tears based on their antecedents, beginning from those more prominent in early development: (1) physical pain tears; (2) (egocentric) attachment-related pain tears; (3) empathic, compassionate pain tears; (4) societal pain tears; and (5) sentimental or morally based tears.

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ANTECEDENTS AND CONTEXT OF ADULT EMOTIONAL CRYING

When adults are asked what triggered their most recent crying episode, the situations they typically report include conflicts, minor personal failures, criticism, rejection, sad music, and sentimental movies (Vingerhoets, 2013). Although one might think that major emotional events, such as the death of a loved one, divorce, physical pain, weddings, or the birth of a child, would be reported as the primary triggers for crying, these strongest elicitors of tears are quite rare in most humans’ lives. Thus, we cry most often for more mundane and idiosyncratic reasons, which are largely dependent on personal and situational context, and which do not appear to have a strong, universal tear-eliciting capacity. Indeed, exposure to an emotional event by itself often is not sufficient to elicit tears—the person likely needs to be in a particular mental and/or physical state and situational context for tears to come.

In addition to situational antecedents, there are a wide variety of emotional states that may mediate the relationship between situational antecedents and tears (Vingerhoets, Van Geleuken, Van Tilburg, & Van Heck, 1997). Feeling powerless/helpless is the most common emotional trigger, especially when combined with emotions such as sadness, anger, fear, frustration, or disappointment. In the case of positive emotions, tears are particularly associated with feeling overwhelmed with joy, elation, or gratitude. While it is impossible to create universal lists of crying-eliciting situations, there can be little doubt that helplessness and hopelessness have a strong, universal power to elicit tears, particularly when such emotional states are associated with attachment-related issues such as bereavement, romantic break-ups, or moves (Denckla et al., 2014; Vingerhoets, 2013).

Although crying has many common underlying themes, there are still a number of individual differences in crying behavior that have been observed in adults. One of the most notable of these is the significant gender difference in crying behavior. Recent data show that adult women cry on average two to five times a month, and men about once every two months, although there is considerable interindividual and intercultural variation (Rottenberg, Bylsma, Wolvin, & Vingerhoets, 2008; Van Hemert, Vijver, & Vingerhoets, 2011; Vingerhoets, 2013; Vingerhoets & Scheirs, 2000). Regarding antecedents, women tend to cry more in conflict situations (“powerless anger”), whereas men cry relatively more often due to positive reasons (Vingerhoets, 2013). In the case of more dramatic situations (bereavement, romantic break-up, homesickness), the gender differences in crying are limited.

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Individual differences in crying also depend on other variables, including personality factors, attachment style, mental health, culture, socialization, whether or not one is in a romantic relationship, and previous exposure to traumatic events. For example, individuals with high levels of neuroticism, extraversion, and empathy tend to cry more (Rottenberg, Bylsma, Wolvin, & Vingerhoets, 2008; Vingerhoets, 2013; Vingerhoets, Boelhouwer, Van Tilburg, & Van Heck, 2001), whereas dismissively attached persons cry relatively less (Laan, Van Assen, & Vingerhoets, 2012).

Bekker and Vingerhoets (2001; see also Vingerhoets, 2013) developed a model to illustrate that each of the following four factors (including combinations of factors) likely contribute to individual and group differences in crying. First, individuals or groups may have different degrees of exposure to emotional situations (e.g., women or individuals in romantic relationships may have more exposure to emotional situations, both in leisure time (e.g., a gender-specific selection of emotional movies or literature, arguments with one’s romantic partner) and work settings (e.g., more women work in health care and men in technical and other less social professions)). Second, individuals or groups may differ in the way they appraise potentially emotional situations. Third, individuals likely have different crying thresholds, which may be related to physical and psychological factors, including health status, hormonal changes, and sleep deprivation. Finally, the fourth factor is the (learned) capacity to control one’s tears and, relatedly, the social acceptance of tears.

FUNCTIONS OF HUMAN EMOTIONAL CRYING

There are a number of theories about the functions of human emotional tears. These theories generally fit into two broad categories: (1) intraindividual: those focusing on the effects of crying on the crier him- or herself, and (2) interindividual: those addressing the effects of crying on others.

Intraindividual Effects

Theories focusing on the intraindividual effects of crying primarily originate from the psychodynamic tradition and are strongly connected to the concept of catharsis (e.g., Breuer & Freud, 1895/1955; Bylsma, Vingerhoets, & Rottenberg, 2008; Koestler, 1964; Sadoff, 1966). According to these views, the production of tears is considered to be a sort of safety valve, serving to release superfluous emotional energy. Similarly, other theorists view crying as a method of releasing or discharging tension that has been built up by emotions inhibited from expression or with which an individual cannot otherwise properly cope (Bindra, 1972; Miceli & Castelfranchi, 2003). Tears, thus, may reflect feelings that cannot be expressed or consummated in other behaviors. Such theories of crying postulate that if this built-up tension is not released via tears, it may have a negative impact on bodily functioning and cause psychosomatic dysfunction. Thus, crying is considered cathartic and believed to result in mood improvement following crying, which promotes one’s health, whereas the inhibition of emotional tears is seen as detrimental to physical functioning. There is some limited evidence that suppressing tears may have negative mental and physical effects (Bylsma et al., 2008; Vingerhoets & Bylsma, 2007a).

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Irrespective of the real intraindividual effects of crying, beliefs about the cathartic benefits of crying may influence how individuals use their crying for mood management. For example, Simons, Bruder, van der Lowe, and Parkinson (2013) found that, when participants were asked about the reasons why they sometimes continue crying in sad or upsetting situations, they reported primarily doing so for the anticipated personal benefit or relief (rather than to influence the behavior of others). Also, in a recent study by Hanser, Ter Bogt, Van Tol, Mark, and Vingerhoets (2016), crying was reported to be the second (next to listening to specific music) most frequent behavior displayed when one is in need of self-comfort.

Moreover, Cornelius (1986) examined popular magazine articles spanning 140 years regarding the health effects of crying and found that 94% of the identified articles qualified crying as beneficial for one’s well-being, even warning readers that suppressing tears could be deleterious to the body and mind. However, the empirical literature reveals a rather complex pattern of findings concerning the effects of crying on mood and well-being (Rottenberg, Bylsma, & Vingerhoets, 2008), with results heavily dependent upon the research methodology employed (Bylsma et al., 2008; Gračanin, Bylsma, & Vingerhoets, 2014; Rottenberg, Bylsma, & Vingerhoets, 2008). For example, an international study on adult crying (ISAC), containing survey data from over 5,000 men and women from 37 countries, found a strong consensus among respondents that crying helps them to feel better (>70%). However, when asked specifically about their most recent crying episode, only about half of these very same respondents reported experiencing a positive mood change after crying (Bylsma et al., 2008; Vingerhoets, 2013). In addition, in a study in which women completed daily mood diaries that included their crying episodes from that day, the reports of mood benefits after crying were just around 30% (Bylsma, Croon, Vingerhoets, & Rottenberg, 2011). And in quasi-experimental studies in which volunteers were exposed to sad movi...

Table of contents

• Cover Page
• When Therapists Cry
• Praise
• Title
• Copyright
• Dedication
• Contents
• About the Editor
• List of Contributors
• Acknowledgments
• Introduction
• Part I The Tracks of Our Tears: An Orientation to Crying
• Part II Constructs of Crying: Understanding Tears Through Theory
• Part III the Clients with Whom We Cry
• Index