Crying Behavior in the Human Adult by Barry M. Bernfeld, Ph.D.

Several years ago, a study was completed by William H. Frey II, Ph.D; Carrie Hoffman-Ahern; Roger A. Johnson, MD; David T. Lykken, Ph.D; and V.B. Tuason, MD, on the "Crying Behavior in the Human Adult." Specifically, crying behavior was studied in 286 females and 45 males with regard to crying frequency and duration of crying episodes. In addition, a study of 99 monozygotic (identical) and 46 dizygotic (fraternal) twin pairs was investigated to determine if any genetic contribution to crying frequency could be demonstrated. The following review is based on abstracts and personal conversations with Dr. Frey.

Crying behavior was studied in 286 females and 45 males ranging in age from 18 to 75 years (mean of 30 +1 years). Men volunteered for the study much less often that women, and monozygotic twins volunteered more often than dizygotic twins. Subjects kept records of all emotional and irritant crying episodes for a period of 30 days. Information such as date, time, duration, reason for crying, thoughts, emotions and physical components, such as "lump in throat," watery eyes vs. flowing tears, etc. An emotional crying episode was defined as "increased production of tears as a result of emotional stress." Irritant crying episodes were defined as the "increased production of tears as a result of direct eye irritation such as chemical (onions) or physical irritants (foreign objects)."

The study was conducted with five different subpopulations, each differing in its demographics and method of selection. The first group comprised of 35 females (29 + 2 years old) and 10 males (27 + 6 years old), university students and employees who responded to an advertisement for volunteers in a crying study. The second group comprised of 90 females (36 + 1 year ) and 5 males (34 + 8 years), hospital employees who responded to a verbal invitation to take part in a crying study. The third group consisted of 50 females (24 + 1 year) and 19 males (28 + 2 years), paid subjects who responded to a newspaper ad to "participate in a behavioral study" for money. No mention of crying was made in the ad. The fourth group was composed of 99 females (30 + 1 year) and 10 males (30 + 7 years), twins who responded to a written invitation to participate in a crying study. The fifth group comprised 12 females (33 + 4 years) and 1 male (26 years) who learned of the study from news media and offered to participate.

Each of these five subpopulations was then divided into two groups - those subjects who met all the psychiatric status criteria and those who failed to meet one or more of the criteria. The criteria were as follows: no diagnosed psychiatric illness, no medication for psychiatric illness or no mental health counseling in the last six months; no episode of depression lasting at least one week in the last six months; no evidence of depression as indicated by the Zung depression scales; no evidence of labile or histrionic personality disorder as indicated by answers to 11 questions taken primarily from the current diagnostic manual of the American Psychiatric Association. Of the 331 subjects, 62 percent met all the mental health criteria and represented the "normal population" (quotation marks mine). Data from the other 38 percent were described separately. Interestingly, although each of the five subpopulations differed in demographics and method of selection, the mean crying frequency and mean duration of crying episode did not differ significantly among these subpopulations.

The mean emotional crying frequency for normal females (5.3 + 0.3 episode per month) was significantly greater than (1.4 + 0.4 episodes per month) of "normal males." While only six percent of the females had no emotional crying episodes in the 30 day recording period, 45 percent of the males had no crying episodes.

That women cry five times as much as men does not seem surprising, given the social taboos associated with crying that many men feel. Although this study is representative of the adult, primarily white Minnesota population, it is reasonably clear that the trends reported can be generalized to a much broader population, both in the United States in other countries.

No significant correlation of emotional crying frequency was found with regard to age. This is a particularly encouraging and important observation, for it seems to indicate that humans, regardless of age can continue to - and rediscover the ability to cry in an emotional way.

In my own study of ACTH (Adrenocorticotrophic Hormone), there was also shown to be no correlation between ACTH content of tears and age. These observations are encouraging to me because I think they speak of the human ability to cry in a curative fashion, without any loss of frequency, intensity, ACTH content, etc., as a result of aging.

Interestingly, of the "normal" female subject, 41 percent reported that they were under some unusual stress during the recording period. However, the mean crying frequency of these subjects did not differ significantly from those female subjects who reported no unusual emotional stress. Females who reported that their general feelings about emotional crying were positive amounted to 73 percent as compared to males, 58 percent who felt positive about emotional crying.

A crying frequency of (8.0 + 1.5 episodes per month) was obtained for 24 females whose scores on the Zung scale indicated current depression. While this is a significantly higher crying frequency the "normal" group, the range of crying frequency for the depressed group (0-31 episodes per month) is quite similar to the normal population ( 0-29 episodes per month). I cannot agree more strongly with Dr. Frey when he says, "the considerable overlap suggests the usefulness of crying frequency as a diagnostic symptom of depression may be quite limited." In my experience, the ability to cry in most cases is an important diagnostic symptom because it indicates that repression has broken or is breaking down. The return of affect and intense feeling I take to be a sign of health.

In spite of the clear difference between sexes regarding emotional crying frequency, the average duration of crying episodes of "normal" females ( 6 + 1 minute) did not differ from that in crying episodes of "normal" males (6 + 2 minutes).

Female crying increased twofold between 7 and 10 p.m. I find this particularly interesting because the 7-10 p.m. time period is exactly when groups are held at the Primal Institute. For most people, this represents the end of the work day, as well as the end of many other responsibilities, which in my opinion is conducive to "letting go" and allowing oneself to cry deeply. The pressure of having to "structure up" and return to work generally strengthens the defenses and prohibits deep crying. That this trend was observed in a "non-patient" population supports our view that psychotherapy sessions of limited time, usually one hour or 45 minutes, fitted into the work day, do not, by their very structure, encourage deep feeling.

Flowing tears occurred in 47 percent of all female crying as compared to only 29 percent of male episodes. Sobbing, the convulsive inhaling and exhaling of air, occurred in only 14 percent of female crying episodes and in 10 percent of male crying episodes. No correlation of emotional crying frequency with any of 11 substantive personality scales could be demonstrated for 65 females who completed the Differential Personality Questionnaire. Also, a study of estimated crying frequency in 99 monozygotic and 46 dizygotic twin pairs and a study of recorded crying episodes in 26 monozygotic and 9 dizygotic pairs failed to demonstrate any genetic contribution to crying frequency.

85 percent of the females and 73 percent of the males reported that they generally felt better after crying.

The purpose of psychogenic lacrimation is unknown, although many theories regarding its functions have been proposed. Ashley Montagu had pointed out that the intake and expulsion of air that occurs in sobbing would quickly dry out the sensitive mucous membranes if tears did not keep them moist. He suggests that mucosal dehydration in the absence of tears could increase the risk of infection. While this may be one of the functions of emotional tearing, Dr. Frey's clinical experience as well as our observation at the Primal Institute indicate that sobbing is not present in all crying and tearing episodes. Frequently tearing occurs in the absence of sobbing. And lastly, humans do not excrete tears while running or engaging in other forms of rigorous exercise where rapid breathing is increased. It therefore seems unlikely that tears are required to protect against the effects of rapid breathing.

Dr. Frey has emphasized that psychogenic lacrimation is an exocirne process. He has hypothesized that like other exocrine process of urinating, defecating and exhaling, emotional tearing may be involved in removing waste products or toxic substances such as ACTH from the body. From this psychobiochemical view we can understand why so many people, "normal" as well as "patient populations," report feeling better after crying. Not only is the venting of emotions liberating, but the actual chemical composition of the tears themselves may be involved in increased feeling of well-being. This theory suggests that tears of emotion may be chemically different from other types of tears; i.e., irritant. This has been shown to be the case regarding some substance, specifically protein concentrations but no chemical found in emotional tears has been shown to be associated with emotional stress. However, in my study of ACTH in Emotional vs. Irritant Tears, a dramatic but not statistically significant trend indicated that there is strong evidence to support this theory and that an increased sample size may have resulted in statistical significance.

To summarize the findings by Dr. Frey, et al., we see that:

(1) Women cry five times as much as men.
(2) Typical crying episodes last 6 minutes for men and women.
(3) Tears are more often shed between 7 and 10 p.m.
(4) No correlation of age with crying frequency exists.
(5) 85 percent female and 73 percent male report they feel better after crying.

I find it exciting that research from any areas seems to support the work at the Primal Institute. That crying is natural, healthy and curative has always been our position, and I feel confident that more and more research will shed light on the natural healing abilities of humans in the years to come. It is ironic in a way that science seems a step behind "common sense." Every animal knows that its infants are fragile and need nurturing and mothering. In the past years we have seen the recognition that babies need their mothers, birth should be more gentle, etc. Crying, which should be the most natural, accepted way of coping with pain, stress, sorrow - but which, for many reasons, has been swept under the carpet, is hardly mentioned in psychiatric literature. Now we seem finally to be recognizing that crying is good for people; a uniquely human response to pain, an ability we can retain regardless of age, sex or race. That science is showing that tears differ chemically, that people feel better after crying that toxic substances may be removed via tears is exciting. However, we seem to be in the position of having to rediscover so many of our basic truths that it make one wonder how we forgot them in the first place.