In Praise of Therapeutic Crying

Too often these days, I find that many clinicians are unaware of the difference between clients’ therapeutic crying—an extremely potent healing experience of acknowledging and spontaneously processing emotional memories—and situations in which clients are forced to deal with an overwhelming incident that takes them beyond their coping capacity and makes them feel vulnerable. It’s as if these therapists see a warning sign whenever clients start to move into emotionally intense territory that says “Beware of Retraumatization!” In their well-intentioned but mistaken assumption that clients will experience increased suffering and might drop out of treatment, some therapists fail to recognize the value of therapeutic tears in alleviating a presenting complaint or dissolving chronic symptoms. What’s most striking is that just a minute or two of deep crying can bring about these changes, although that’s likelier to happen with people who haven’t suffered numerous deeply hurtful experiences and/or ongoing emotional neglect.

Facilitating therapeutic crying isn’t a complicated process. Most of the time, the less the therapist does, the better. Here’s an example of what I’m talking about. The wife of a couple married for two years called the clinic where I was working, saying she felt emotionally distant from her husband and needed marital counseling. After two sessions with the couple, I scheduled a few with the wife. At the beginning of one session, she described an upsetting encounter with her husband, focusing on the factual details and skimming over her feelings. I asked if she could say more about how she felt. After collecting herself for a few moments, she tried to, but I could see that she was struggling with strong, unexpressed emotions. Sensing that I could trust our relationship at this point, in my most supportive tone, I said, “Please try again.” Her immediate reaction was to stare over my shoulder at the window behind me. A few seconds later, her lower jaw began to quiver, her hands flew to her face, and she erupted into deep sobbing, which lasted about 30 seconds. Tears flowed for about another minute.

When her crying came to an end, she dumped her tissues into the wastebasket and looked directly at me with a radiant face. With no more than a second’s hesitation, she exclaimed, as if she couldn’t quite believe it herself, “I feel like I have a new toy. And the new toy is me!” A “new toy” meant that she was now in touch with a depth that she’d always sensed was within herself, but had feared because it was connected to a hurt that she’d been afraid to feel. The fear of opening up to this hurt had kept her emotionally distant from her husband.

My introduction to the power of therapeutic crying was as a student therapist with a 30-year-old woman who’d contracted polio at age 6. Only her legs were affected; she needed crutches and a wheelchair to get about. She was separated from her husband and lived with her parents and 8-year-old daughter, getting by on a small income from doing part-time typing at home. Attempting to make her feel guilty about depriving him of their daughter, her husband harassed her with phone calls and letters, in which he threatened to kidnap the child. My client believed he meant it.

This woman had come to our agency after becoming housebound with an intense fear that something terrible would happen to her if she were in a car or had to make her way down even a step or two. She’d never before been afraid of being in a car, and was quite adept at adjusting her body to avoid serious injuries in a fall. She’d seen two previous therapists without success. From her case record, I had no idea what was causing her anxiety. For the first several sessions at her parents’ house, I just listened attentively and encouraged her to talk about whatever she chose to.

Eventually, as her trust in me increased, she brought up her experience of contracting polio as a young girl. Though that had happened 24 years previously, for her, it seemed like the day before. Her favorite grandfather, and quite probably the person she felt the closest to, had visited her as soon as he was allowed into the hospital ward. He’d teared up and said how sorry he was. When he missed his next visit, she asked her mother why. Apparently not thinking about her choice of words, her mother said, “The day he came to see you, he had a heart attack and died.”

When my client awoke the next morning, the bed next to her was empty. A boy about her own age, also afflicted with polio, with whom she’d become friendly, was no longer there. She asked a nurse what had happened to him. She said, “God took him last night,” and, bless her soul, added, “He only takes good children.” The next time my client went for a whirlpool treatment, she felt that the whirling, gurgling, rumbling machine was a monster that was going to rip her body apart and throw the pieces around the room. She threw a fit and had to be held securely in the pool while she bawled and screamed to get away. (This kind of crying isn’t therapeutic: it’s a forced flight-or-fight reaction.) Every whirlpool treatment after that—and there were many—went exactly the same way.

My client explained all of this in about 20 minutes, cried quite deeply a few times, teared up at other times, and then felt immense relief. It all just poured out of her, as if it had been inside her, frozen in time. What made her cry was that she’d feared that she’d caused her grandfather’s death, and that she’d be punished for it. She suddenly saw that her husband’s attempt to make her feel guilty over their daughter and his kidnapping threats had reactivated these difficult memories.

Over the next few sessions, she cried about a few other, less traumatic, events for which she’d assumed responsibility. A few months later, she contacted the state department of vocational rehabilitation for help in finding a job as a typist. Her counselor there arranged for the state to put a down payment on a car with levers on the steering wheel for the accelerator and brakes. She found permanent employment and drove herself to her new job, where, a few months later, she met her future husband.

——

How can therapists help clients have a therapeutic cry? It’s really very simple: have the utmost respect for this natural process and be patient. Tears can help people heal from hurtful psychological experiences in life, just as there are natural body processes that promote physical healing. Creating the right conditions for therapeutic crying begins with developing the bond of trust and safety that enables clients to share their hurts with you, however circuitous the route may be. It’s through that bond and the experience of released emotion that people can reclaim parts of themselves that they’ve felt too frightened to acknowledge and own.

Therapeutic crying involves a sympathetic–parasympathetic (S-P) sequence. The S-phase is characterized by the buildup of the symptoms of unresolved hurt, paired with the client’s sense of being in a supportive setting. While the client may appear to be upset, there’s a deep underlying sense that something quite profound is happening, and in the absence of any coercion to reveal more than he or she may care to, the client is a willing participant. With continuing support from the therapist, the S-phase reaches a psychophysiological peak of intensity and immediately transforms to the P, or healing, phase. When that happens, all heightened physiological responses drop precipitously, and the S-phase psychological reactions of fear and/or anxiety are replaced by the client’s reexperiencing of the hurtful event, or a part of it, as if it were happening in the present, and simultaneously experiencing a therapeutic emotional release.

Therapeutic crying, the most all-encompassing healing agent of which I’m aware, works most effectively if it’s respected and nurtured with sensitivity and care. In this age of assembly-line, protocolized psychotherapy, we always need to remember that it can only happen when clients experience the therapist as sufficiently interested in them as people, and not just a bundle of symptoms to be labeled and managed.