Receiving the diagnosis of a terminal illness sweeps people into a journey that is peppered with tears. However, not all tears are due to sadness and despair.
In my mother's journey with cancer, I had sobbed uncontrollably on the day we received news that the cancer had spread. I had also cried when we talked about how the cancer had transformed our lives and brought the family closer together. I had also cried while I recounted my experiences to friends and told them, "I don't even know why I am crying."
The message to people who are grieving is this: crying is a form of release for different emotions. What you cry about may also be reveal what issues are bothering you the most and this feedback can be useful in helping you figure out how to heal.
This article is about the different emotions that lead us to cry and the utility of crying.
Types of Tears
Both lacrimation and crying leads to secretion of tears by the tear glands of the eyes.
Lacrimation refers to the non-emotional shedding of tears (basal and reflex tears). Basal tears keep the eye lubricated and smooth. Reflex tears happen in response to irritants such as foreign particles or vapours (e.g. onions).
Crying refers to the shedding of tears in the absence of irritation to the eye (psychic tears). Psychic tears, also known as emotional tears, have a different chemical composition from basal and reflex tears. It contains a higher concentration of stress hormones including the neurotransmitter leucine enkephalin, a pain-killer produced when one experiences stress. The significance of this fact is not yet known but scientist theorise that it could be a contributing reasons why people feel better after they cry.
When a tear is produced by the tear gland, it spreads across the eye when you blink. When you cry, these tears can either overflow and run down your cheek or it can drain via the lacrimal punctum and flow out through your nose. This is the reason why your nose starts to run when your eyes start to cry.
When do we shed emotional tears?
Tears can be shed as a result of intense emotion (such as sadness, joy, anger, fear) or as response to pain. There have been many attempts to categorise the types of crying.
Broadly, crying can be classified into the type of emotions that it expresses: positive and negative. For the purpose of this website, I will be focusing more on crying as an expression of grief.
There is one form of categorisation that explains crying from the perspective of spatial and temporal dimensions:
Spatial
Spatial perspective explains sad crying as reaching out to another place or time. This can happen when you are:
Yearning to return to a time when there wasn't so much suffering in your life e.g. to a time before receiving the diagnosis of terminal illness
Wanting to be with a person who has passed on
Longing to be in a physical location that isn't where you are in the present e.g. home sickness after spending many days in the hospital
Temporal
Temporal perspective explains sad crying as due to looking to the past with regret or to the future with dread. This can happen when you are:
Devastation that your future is not what you envisioned
Regretting not spending more time with someone before they passed on
Not knowing how to move on with that person no longer in your life
Joyful Tears
In contrast to sad tears, joyful tears occur as a result of a sudden, unexpected realisation of something beautiful and in appreciation of the here and now. In the context of this website, joyful tears can happen amidst a background of grief. For example:
Accomplishing goals that one previously thought was unachievable with a terminal illness e.g. witnessing a significant family milestone like the birth of a child, marriage, fulfilling a bucket list item
Being forgiven or forgiving someone whom you have not spoke to in a long time because of a previous conflict
Being able to properly express your gratitude to your loved ones for being by your side
What is the utility of crying?
Crying can serves many purposes, the purposes most relevant in the context of terminal illnesses are highlighted here:
Crying is an outlet for intense emotions
When you are overwhelmed with emotions, it can be difficult to think logically and systematically. Releasing these emotions in the form of crying also results in the body secreting oxytocin and endogenous opioids (also known as endorphins).
Once these endorphins are released, your body can go into a "numb" stage and you may feel more calm. This clarity of mind can be useful in sorting your thoughts and dealing with problems.
When and what we cry about reveals the issues that affect us the most deeply
In an interview with Vox, Dr Ad Vingerhoets, a Dutch psychologist, made a comment about the process of crying: "Apparently there is some knowledge in my body that I'm not aware of. I tend to say 'Tell me what makes you cry and I will tell you who you are.' "
Crying is a signal to people and therapists of the issues that bother us the most. It may have been a problem that you were not aware of, or something that you were subconsciously trying to bury. There are many people who feel completely fine when carrying out daily routines. But once their therapist prompts them to talk about a certain issue, the floodgate of tears open.
When you understand what is hurting you, you can begin to take steps to improve your situation. For example, in the situations mentioned above:
Crying helps us to connect with people
You may have heard of the theory that crying is a form of non-verbal communication that elicits altruistic helping behaviour from others. When you open up to someone and cry about a matter, seeing them shed a tear in response to your suffering is a non-verbal response from the other party that shows that he/she acknowledge and empathises with your grief.
Acknowledgement of grief and being surrounded by people who understand your grief are both protective factors in the process of healing.
Conclusion
The act of crying and understanding the reason behind it can help you better deal with the problems that you have on hand. It is exceptionally useful when used in conjunction with other coping strategies.
Even though crying is usually seen an expression of grief, it can also come from expression of gratitude, the act of forgiving and being forgiving, and from the joy of accomplishing goals that one previously thought was unachievable.
References
Robinson, N., Hill, C. E., & Kivlighan, D. M. (2015). Crying as communication in psychotherapy: The influence of client and therapist attachment dimensions and client attachment to therapist on amount and type of crying. Journal of Counseling Psychology, 62(3), 379-392. https://doi.org/10.1037/cou0000090
Newman J. D. (2007). Neural circuits underlying crying and cry responding in mammals. Behavioural Brain Reseach, 182(2), 155-165. https://doi.org/10.1016%2Fj.bbr.2007.02.011
Vox (2019). Why do we cry? - Glad You Asked S1. https://www.youtube.com/watch?v=1XOo1OJFAeQ&ab_channel=Vox
Healthline (2017). 9 Ways Crying May Benefit Your Health. https://www.healthline.com/health/benefits-of-crying#selfsoothing