A clinical practice review of crying research.

Bylsma, Lauren M.; Gračanin, Asmir; Vingerhoets, A.J.J.M.

doi:10.1037/pst0000342

Cited by 14 publications

(16 citation statements)

References 109 publications

(208 reference statements)

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“…Depressed individuals also show alterations in their crying behavior, such as increases in crying frequency, although decreases in the ability to cry have also been observed at more severe levels of depression (Rottenberg et al., 2008). Crying has also been long considered an important focus of psychotherapy that may facilitate emotional processing, attachment, and interpersonal functioning (Bylsma, Gračanin, et al., 2020); however, little is known about how crying changes with the course of depression or in response to intervention.…”

Section: Characterization Of Within and Cross‐level Interactions Acromentioning

confidence: 99%

Emotion context insensitivity in depression: Toward an integrated and contextualized approach

Bylsma

2020

Psychophysiology

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Major depressive disorder (MDD) is characterized by pervasive mood disturbance as well as deficits in emotional processing, reactivity, and regulation. There is accumulating evidence that MDD is characterized by emotional patterns consistent with environmental disengagement, as reflected in attenuated positive and negative emotional reactivity, consistent with Emotion Context Insensitivity (ECI) theory. However, MDD individuals vary considerably in the extent to which they exhibit specific alterations in patterns of emotional responding. Emotions are complex, multicomponent processes that invoke responses across multiple functional domains and levels of analysis, including subjective experience, behavior, autonomic regulation, cognition, and neural processing. In this article, I review the current state of the literature on emotional responding and MDD from the lens of ECI. I focus on the importance of assessing emotional indices from multiple levels of analysis across development and contexts. I also discuss methodological and measurement issues that may contribute to inconsistent findings. In particular, I emphasize how psychophysiological measures can help elucidate emotional processes that underlie the pathophysiology of MDD as part of an integrated and contextualized approach.

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Section: Characterization Of Within and Cross‐level Interactions Acromentioning

confidence: 99%

Emotion context insensitivity in depression: Toward an integrated and contextualized approach

Bylsma

2020

Psychophysiology

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“…As the field of psychotherapy research progressed, there has been a shift from viewing crying in therapy primarily as having strictly a cathartic value, to a broader perspective emphasising additional effects of crying in therapy, such as its role in insight gained in treatment as well as its relation with the therapeutic alliance (Bylsma et al, 2021; Genova et al, 2020; Nelson, 2007; Zingaretti et al, 2017). It has been suggested that the relationship between crying and the therapeutic alliance can be both positive and negative, depending on the context.…”

Section: Introductionmentioning

confidence: 99%

Crying in psychotherapy among Israeli patients and its relation to the working alliance, therapeutic change and attachment style

Katz

Ziv-Beiman

Rokah

et al. 2021

Couns and Psychother Res

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Patients' crying in psychotherapy can, at times, be an indicator of a healing process and reflect patients' engagement. This study explored the relationships between Israeli patients' crying in therapy, the working alliance, therapeutic change and attachment styles, using similar procedures to the ones used by Genova et al. (2020; Psychotherapy, 58, 160) in a recent investigation of Italian patients. One hundred and thirteen patients completed an online survey in Hebrew about crying in therapy and self-report measures assessing the working alliance, therapeutic change and attachment styles. Our findings revealed that self-reported working alliance was related to the patients' perceptions of their therapist responding to their most recent crying episode with support and compassion. Therapeutic change was associated with a tendency to cry in therapy and higher instances of crying in therapy during the last year. Patients with anxious-preoccupied attachment styles had more faith that crying would lead to being understood by their therapist. Dismissive-avoidant attachment style was related to higher likelihood of feeling like the most recent crying episode helped the patient understand things that they did not understand before and feel like their tears expressed things that words could not. Further, fearful-avoidant, anxious-preoccupied and dismissive-avoidant attachment styles were all related to stronger faith in the therapy relationship strengthening after crying. These findings are in line with, and expand on, Genova et al.'s (2020; Psychotherapy, 58, 160) findings regarding the therapy alliance, crying in therapy and attachment styles. Implications for the relationships between patient attachment style, therapy alliance, therapeutic change and crying in therapy are discussed.

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“…Crying frequently accompanies a variety of emotional situations (e.g., relational conflict, perceived personal failure and loss) and can convey important and clinically useful information about the relationships and situations that matter to the patient (Beck et al, 1979). Different theoretical orientations diverge in what they underscore as the most noteworthy aspects of crying: for example, emotional expression and catharsis in psychodynamic theory, social context and communicative function of crying in interpersonal approaches, and cognitive appraisals in CBT approaches (Bylsma et al, 2020). However, in spite of their differences, there seems to be consensus among the major paradigms that crying in therapy presents unique opportunities for patients to engage in affective experiences and explore their meaning.…”

Section: Introductionmentioning

confidence: 99%

“…Psychotherapy can be a highly emotional process. It is thus not surprising that crying is a common occurrence in this setting (Robinson et al, 2015; Trezza et al, 1988; Zingaretti et al, 2017), with estimates suggesting at least one crying episode in 15–30% of therapy sessions (Bylsma et al, 2020). Crying frequently accompanies a variety of emotional situations (e.g., relational conflict, perceived personal failure and loss) and can convey important and clinically useful information about the relationships and situations that matter to the patient (Beck et al, 1979).…”

Section: Introductionmentioning

confidence: 99%

“…However, there is both theoretical rationale and empirical evidence that crying in some instances may be counterproductive to the therapy process (Beck et al, 1979; Mills & Wooster, 1987). This seems to be the case in particular when patients' tears are perceived by their therapist as manipulative or nongenuine (Alexander, 2003; Bylsma et al, 2020; 't Lam et al, 2018; Trezza et al, 1988).…”

Section: Introductionmentioning

confidence: 99%

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Patient crying during psychotherapy intake sessions: Relationship to patient characteristics and early treatment process

Umphlet

Fiori

Mullin

et al. 2021

Clin Psychology and Psychoth

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The aim of the present study is to further the understanding of who cries at the beginning of psychotherapy and patients' experience of crying in that process. Intake sessions for 53 patients beginning psychotherapy at a university-based clinic were coded for discrete crying segments. Data about patient characteristics were also collected at intake. Results indicate that crying during intake sessions was related to lower global functioning and higher severity of childhood sexual abuse. Furthermore, patients who cried at intake were over four times more likely to also cry at feedback, and those who cried at feedback were almost 12 times more likely to have cried at intake. Finally, crying in the intake session did not appear to be related to patient-or therapist-rated working alliance. Overall, the present study provides valuable information about characteristics of patients who cry at the outset of the therapy process and patients' experience of crying over time in therapy. Findings suggest the need for further research on patient characteristics and aspects of the therapy process that may predict patient crying over the course of treatment, as well as how these early crying experiences may be related to eventual patient outcomes.

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A clinical practice review of crying research.

Cited by 14 publications

References 109 publications

Emotion context insensitivity in depression: Toward an integrated and contextualized approach

Emotion context insensitivity in depression: Toward an integrated and contextualized approach

Crying in psychotherapy among Israeli patients and its relation to the working alliance, therapeutic change and attachment style

Patient crying during psychotherapy intake sessions: Relationship to patient characteristics and early treatment process

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