The Many Reasons Why Therapy Clients Cry

A Clinician's Guide to the Biological Basis of Tears

Jay Efran and Mitchell Green

At the site of the 2010 Chilean mine disaster, the son of miner Florencio Avalos burst into tears when his father was brought safely to the surface. Later that month, Caylee Anthony’s grandmother was shown weeping over her granddaughter’s death. How can two such totally different events---one joyful, one tragic---both elicit tears?

This question puzzles many clinicians, including some who are considered experts in the field of emotional expression. The problem is that few of us have received explicit training in theories of emotion. Therefore, our notions about tears and other forms of emotional release are still partly based on “steam-kettle thinking”---the culturally pervasive but biologically absurd notion that emotions are stored quantities of energy, which, like steam, wreak havoc when bottled up too long or released too abruptly.

Steam-kettle thinking may have intuitive appeal, but it doesn’t provide an adequate guide for dealing with emotionally distressed clients. Moreover, it doesn’t help us answer the question of why people cry when they’re happy. Although our focus here is on tears, the theory we’re about to describe also applies to other forms of emotional expression.

The Two-Stage Theory of Tears

Physiologically speaking, emotional tears are elicited when a person’s system shifts rapidly from sympathetic to parasympathetic activity---from a state of high tension to a period of recalibration and recovery. Depending on the circumstances, individuals typically describe such shifts as “letting go,” “going off duty,” or “giving up.” Of course, nothing is literally “released” when these biophysical changes occur, although the person’s adrenaline level drops and the body relaxes.

The shift from arousal to recovery is almost always triggered by a psychologically meaningful event, such as when lost children finally spot their parents and realize that they’re safe. Typically, children don’t cry when they first realize that their parents are gone; instead, they become hypervigilant and start searching for their missing caretakers. It’s only when the parents reappear---perhaps rounding the corner of the supermarket aisle—that their child “goes off duty,” and tears begin to flow. In other words, tears are elicited during the second, parasympathetic, phase of the two-stage cycle we’re describing.

Although the two-stage arousal---recovery cycle is basically a biological invariant, certain factors affect the timing. Some children---depending on age, temperament, and background---will cry before their parent appears. They may feel safe enough to “go off duty” when, let’s say, a sympathetic store clerk takes them by the hand, offering to help. Young children frequently burst into stage-two tears whenever they exhaust their problem-solving resources, even if no adult is in sight. In evolutionary terms, such meltdowns undoubtedly contribute to survival by alerting nearby caretakers that assistance is required. This works well because under ordinary child-rearing circumstances (what biologists call the “average expectable environment”), potential helpers are almost always within earshot.

Adults and children sometimes cry in connection with problems that haven’t yet been solved, and perhaps never will be. In these instances, tears indicate that the person is at least temporarily giving up the struggle. Although this is commonly thought of as a “breakdown,” we optimistically consider it a potential breakthrough. By backing away from an overwhelming issue, the system can husband its resources and regroup for a fresh assault.

Although phase-two recuperation is almost always healthy for the system, many clinicians overreact to an adult’s tears. Our evolutionary programming, geared to raising infants, prompts us to launch into emergency action when anyone cries. We feel obliged to help, but with adults, we may not be sure what to do.

Clinicians too can feel an urge to rush in and “fix things” that aren’t broken. This often makes matters worse. Therefore, in accordance with our theoretical model and clinical experience, we offer some suggested dos and don’ts for dealing with adult clients who are crying.

The first rule is to avoid “crowding” the client with an anxious flurry of pats and hugs. If you’ve cried recently yourself, you may remember how uncomfortable it is to be fussed over at a time when you’re trying to remain connected to your experience. Tearful individuals need a relaxed, safe space in which to process their thoughts and feelings---frantic attention isn’t helpful. This is exactly the wrong time to pepper them with questions about why they’re crying or anxious inquiries about “what’s wrong?” There’ll be plenty of time for debriefing later.

Because the urge to “do something” is strong, we have to remind ourselves to relax in the presence of adult tears and allow the natural recovery phase to run its course. When a person is crying, there should be no hurry to move on in a session. Over the years, our therapeutic mantra has been “If tears are flowing, something worthwhile is happening.” Either there’s been a meaningful breakthrough, or---as we indicated earlier---the person is giving up an approach that wasn’t working.

Certainly avoid the temptation---generated by your own anxiety---to delegitimize the person’s tears (“There’s no need to cry about it!”) or to issue false reassurances (“Everything will be fine!”). Even professionals, who ought to know better, sometimes feel an urge to stop the person from crying, as if stopping the tears would eliminate the problem. This is a bit like trying to fix a car by disconnecting the “check engine” light.

When the tearful episode winds down, we typically ask, “What’s the thought that helped you cry?” That question tends to elicit more tears (and additional stress reduction). Notice that we say “what helped you cry” rather than “what made you cry.”

Technically speaking, tears, laughter, tantrums, and trembling aren’t emotions: they’re outward signs of abrupt shifts in neurophysiology. The emotion, as it so often is in art and life, is more complicated than any simple formulation.

This blog is excerpted from “Why We Cry". Read the full article here. >>

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Topic: Anxiety/Depression | Children/Adolescents

Tags: breakthrough | child-rearing | emotion | neurophysiology | parents | psychotherapy | stress reduction | therapist | therapy | Jay Efran | networker | Mitchell Green | crying | cries | client | patient

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