Tears for Trauma:
Birth Trauma,
Crying, and Child
Abuse
Aletha Solter, Ph.D.
ABSTRACT: Infant crying has been linked to child abuse.
In a survey of battered infants, eighty percent of the parents reported
that excessive crying by their child triggered the abuse. It is therefore
vitally important to help parents understand and cope with their babies’
crying. This paper presents evidence supporting a stress-release theory
of infant crying, with particular emphasis on birth trauma as a source
of stress.
Birth-traumatized infants need to cry extensively in order to
release the physiological tensions resulting from the trauma. Crying removes
excess stress-related chemicals from the body and serves the purpose of
restoring the body’s chemical balance after a stressful event has occurred.
Crying is a beneficial physiological process that allows people to cope
with stress and can be considered an inborn healing mechanism. This crying
puts them at high risk for child abuse, which is one possible explanation
for the correlation between birth trauma and later violent behavior.
Appropriate and inappropriate responses to infant crying are discussed.
Babies benefit immensely from being held during crying episodes by an attentive
and empathic person who can calmly acknowledge and accept their feelings.
Were this new information about the role of crying in the resolution
of trauma and the restoration of homeostasis to be widely applied, it is
suggested we would see a dramatic reduction in the number of instances
of child abuse and the lifelong impact of traumatic birth would be minimized
because babies would be healing themselves in a supportive environment.
When parents receive enough information and support, loving holding will
replace the urge to hit or even distract their crying babies. This will
have a dramatic positive impact on babies’ well-being, as well as on the
parent-child relationship.1
The Trouble With Crying
A baby’s crying can invoke powerful feelings in caretakers. When asked
to describe their feelings when they were unable to quiet their crying
babies, new mothers confessed a range of emotions, including exasperation,
lack of confidence, fear, anxiety, confusion, anger, and resentment. Some
even reported feeling extremely hostile towards their infants (Jones, 1983).
Not surprisingly, infant crying has been linked to child abuse (Frodi,
1985; Murray, 1979). In a survey of battered infants, eighty percent of
the parents reported that excessive crying by their baby triggered the
abuse (Weston, 1968). It is therefore vitally important to help parents
understand and cope with their babies’ crying.
The baffling thing about crying is that babies often cry for reasons
that appear unrelated to any immediate need. In fact, it has been observed
that about one-third of the instances of crying in newborn infants are
of undetermined cause (Aldrich et al., 1945) and that young babies cry
on the average of one-and-a-half to two hours per day (Brazelton, 1962).
Crying duration typically peaks when the infant is six to eight weeks of
age and then gradually declines.
Many conflicting opinions about crying are found in parenting manuals.
Most of the advice is based on the assumption that all crying in infants
is undesirable and asserts that the appropriate caretaking response is
to quiet or "soothe" the baby. However, I have seriously questioned this
assumption in my book, titled The Aware Baby (Solter, 1984).
In this article, I will review the traditional explanations for crying
and then present evidence for a stress-release theory of crying.
Traditional Explanations for Crying
There are numerous traditional explanations for extensive crying in
infants. Three of the most common ones are the gastrointestinal theory,
the allergenic theory, and the psychosocial theory.
Perhaps the most common of these explanations is the gastrointestinal
theory, which states that infants cry because they have abdominal pain
(Illingworth, 1954). The term colic originally referred to abdominal
pain but has become essentially synonymous with crying behavior. Thus,
parents are led to believe that whenever babies cry for no apparent reason
they must be suffering from abdominal pain, resulting perhaps from an immature
digestive system.
The colic theory, however, does not fit with Dr. Spock’s observation
that, "The strange thing is that the colicky or crying baby usually prospers
from the physical point of view. In spite of hours of crying, he continues
to gain weight . . . better than average" (Spock, 1976). Furthermore, no
gastrointestinal malfunction has been found in babies who cry extensively
(Jorup, 1982; Wessel, 1965).
To further counter the colic theory, there is evidence that many
older babies continue to have crying episodes, even though their digestive
systems would presumably be fully mature by then. In an extensive survey
of crying babies, only twenty-five percent had stopped by three months
of age, and twenty-five percent were still crying at nine months of age
(Kirkland, 1985). The explanation of crying being purely the result of
abdominal pain due to an immature digestive system is therefore inadequate.
Related to the gastrointestinal theory is the allergenic theory.
When infants are bottle fed, an immediate suspect is an allergy to cow’s
milk protein. It is known that some babies are allergic to cow’s milk,
and this possibility should be considered in all cases of extensive crying.
However, when thirty-two normal, four-week-old infants with colic were
switched from cow’s milk to soy milk, there was no reduction in either
the duration or frequency of crying, or in intestinal gas production (Barr
et al., 1987).
Some mothers report that their breast-fed babies cry less when certain
other offending foods are eliminated from the mothers’ diets. However,
unless the foods are first eliminated and then reintroduced in the mother’s
diet to see if the crying increases, one can never be certain that the
mother’s consumption of the food actually caused the crying. Nevertheless,
there does seem to be evidence that food allergies and sensitivities can
be a possible factor in the etiology of infant crying, although this fails
to account for the majority of cases.
The most common psychosocial theory of crying implies that babies
cry because their mothers are lacking in love or confidence, or are anxious
or hostile. However, the studies on this are inconclusive. Although correlations
have been found between mothers’ lack of confidence and anxiety levels
and the amount of crying by their infants (Lakin, 1957; Stewart, 1954),
it is quite likely that a mother’s lack of confidence could be the result
of having a crying baby rather than the cause.
Thus, the various traditional explanations for crying during infancy
are inadequate, and the majority of cases of extensive crying remain unexplained.
Crying as Tension-Release Mechanism
So why do babies cry? I have found it useful to distinguish two reasons
for crying. A primary function of crying is to communicate needs and discomforts
that require a caretaking intervention—such as feeding, holding, stimulation,
or a change in position. When an infant expresses a need by crying, it
is the caretaker’s responsibility to discern the infant’s need and to satisfy
it as accurately and as promptly as possible.
In my book, The Aware Baby, I have proposed that a secondary
function of crying is that of a stress-release mechanism (Solter, 1984).
Crying allows babies to release the pain and tension resulting from physical
or emotional stress and trauma. As an illustration, babies typically cry
when a vaccination is administered but also for several minutes afterwards.
In fact, the crying may last much longer than the actual physical pain,
because there is emotional pain as well, consisting of fear, confusion,
indignation, anger, and perhaps even a sense of betrayal. The physiological
process of crying allows all of these feelings, in addition to the physical
pain itself, to be discharged.
Research on the Benefits of Crying
There is considerable scientific research on the physiological and psychological
effects of crying. This evidence supports the theory that crying is beneficial
and serves as a natural stress-release mechanism. I will briefly summarize
some of this research.
Dr. William Frey, a biochemist who studied human tears, compared
tears shed for emotional reasons, which he called "emotionally induced
tears," with those shed because of an irritant such as a cut onion, called
"irritant-induced tears" (Frey and Langseth, 1985).
The biochemical analyses of the two kinds of tears revealed statistically
significant differences, specifically higher protein concentrations in
the emotionally induced tears. Further analyses of these tears revealed
the presence of certain hormones and neurotransmitters that are found to
be present in the body during stress. These substances serve to prepare
the various body organs to cope adaptively with stress. However, since
they are no longer needed after the stressful event is terminated, their
continued presence would maintain the body in a state of needless tension
and arousal.
Dr. Frey concluded from his research that the purpose of crying in
response to stress is to remove waste products from the body through tears,
just as waste products are excreted by urinating and defecating. Crying,
therefore, serves the purpose of restoring the body’s chemical balance
after a stressful event has occurred. Sweating is another mechanism by
which the body rids itself of chemical substances.
Other researchers have measured physiological changes during crying
in adults and have found that crying lowers the blood pressure, pulse rate,
and body temperature, and results in more synchronized brain-wave patterns
(Karle, Corriere, and Hart, 1973; Woldenberg et al., 1976). As these are
generally considered to be measures of tension, the conclusion from these
studies is that crying serves to reduce tension.
If crying removes excess chemicals from the body and also reduces
tension, one would expect it to be related to physical and psychological
health. Several studies have confirmed this. For example, children suffering
from various forms of trauma benefit from therapy that allows the natural
stress-release mechanism of crying (Emerson, 1989; Jewett, 1982; Levine,
1994). Severely disturbed children also benefit from crying. Several therapists
have noted profound and rapid improvements in autistic children after they
were allowed and encouraged to cry and rage during holding-therapy sessions
(Waal, 1955; Welch, 1983; Zaslow and Breger, 1969), and children with extreme
behavior problems have also been cured with similar holding therapy (Magid
and McKelvey, 1987).
These different areas of research all support the conclusion that
crying is a beneficial physiological process that allows people to cope
with stress and can be considered an inborn healing mechanism. Although
newborn infants typically do not shed tears when they cry until they are
several weeks old, they do sweat profusely during crying spells, perhaps
excreting excess stress hormones in that manner until the tear glands begin
to function.
Sources of Stress and Trauma During Infancy
Infancy is far from being a stress-free stage of life. A major source
of stress and trauma during infancy is that caused prenatally and during
the birth process. The field of prenatal psychology has shown that babies
are sensitive, intelligent, receptive, and extremely vulnerable before
birth (Chamberlain, 1992; Verny, 1981). Maternal stress levels during pregnancy
have been found to correlate with the amount of crying in the infant. In
one survey, almost half of the mothers whose babies cried extensively reported
having been under considerable ongoing stress during pregnancy. None of
the mothers whose babies cried less frequently reported any unusual stress
during pregnancy (Kitzinger, 1989).
Birth itself can be an extremely painful, confusing, and frightening
experience for infants. The major kinds of birth trauma result from being
drugged, removed by forceps, cesarean delivery, experiencing prolonged
labor, and oxygen deprivation. After birth, it can be terrifying and confusing
for the newborn to experience sudden coldness, brightness, rough handling,
harsh sounds, or separation from the mother (Janov, 1983). Medical interventions
such as electronic fetal monitoring, heelsticks, eye drops, and circumcisions
are also distressing to infants. Unfortunately, birth trauma appears to
be fairly common. Dr. William Emerson found that fifty-five percent of
a sample of two-hundred children showed signs of moderate to severe birth
trauma (Emerson, 1987).
Traumatic births have a potential for causing lifelong problems.
It is now known that there is a correlation between perinatal complications
and later susceptibility to emotional and behavioral problems, including
schizophrenia, violent crime, and suicidal behavior (Batchelor et al.,
1991; Mednick, 1971; Roedding, 1991).
It has been found that babies whose mothers have experienced a difficult
delivery tend to cry more than babies whose mothers had a more pleasant
delivery. In one survey, mothers whose babies cried the most were significantly
more likely to have had obstetrical interventions or been made to feel
powerless during birth (Kitzinger, 1989). Another study showed that babies
who had problems at birth were more likely to wake up crying frequently
at night during the first fourteen months (Bernal, 1973).
A possible physiological correlate of pre- and perinatal trauma is
that these infants are in a state of tension resulting from an overactive
sympathetic nervous system and an excess of stress hormones. This biological
"fight or flight" response may have been adaptive in helping the infants
survive the birth trauma but may last much longer than needed, resulting
in physiological problems. This increased sympathetic effect might account
for the sleep disorders commonly observed in birth-traumatized infants.
Another consequence might be sluggish digestion resulting from the inhibitory
effect of the sympathetic nervous system on the digestive organs. This
would provide renewed credibility for the colic theory discussed earlier
but with the underlying cause of abdominal discomfort being, in this case,
emotional stress.
The extensive crying that occurs in babies following a traumatic
birth could therefore be a biological stress-release mechanism which allows
excess chemicals to be excreted from the body (through sweat and eventually
tears) and which also provides a release of energy, thereby completing
the physiological stress/relaxation cycle. If the birth trauma was severe,
the baby may have long crying spells every day for several months before
the trauma is completely resolved and homeostasis is attained.
Other sources of stress during infancy include unfilled needs, overstimulation,
developmental frustrations, physical pain, and frightening experiences
that occur during the weeks and months after birth. Babies are extremely
vulnerable because of their lack of information and skills and their total
dependence on others to meet their needs. The ideal goal would be to fill
all needs and prevent all stress in babies’ lives. But some stress is inevitable,
no matter how loving the parents are. Thus, every baby would need to cry
to some extent, even in the absence of any prenatal or birth trauma.
Responding to Crying
How should one respond to a crying infant? First of all, it is important
to check for immediate needs as well as for pain and discomfort. Once all
possible needs and medical causes have been eliminated, it is safe to assume
that the crying is serving a stress-release and healing function. Although
the exact cause of the crying may be difficult to determine, parents and
caretakers nevertheless have an important role to fulfill as listeners.
Babies benefit immensely from being held during crying episodes by an attentive
and empathic person who can calmly acknowledge and accept their feelings.
The approach recommended is similar to the holding therapy for deeply disturbed
children that I mentioned earlier.
In the past, parents were commonly advised not to pick up their babies
every time they cried, for fear of "spoiling" them. It was believed that
no harm could come from leaving babies in their cribs to "cry it out" alone.
Unfortunately, there are still a surprising number of parenting books that
continue to give this harmful advice. When babies’ cries are not responded
to, the inevitable feelings are those of extreme powerlessness and terror.
Babies should therefore never be ignored while crying.
More recently, parents have been advised to respond to every cry,
but to attempt to "soothe" or "quiet" the baby, past the point of filling
immediate needs. Thus, parents have been misled into thinking that their
babies need to be continuously walked, rocked, jiggled, or nursed. A "high-need"
infant may simply be one who has more stress than average (resulting perhaps
from pre- or perinatal trauma) and who needs to cry extensively in order
to discharge tensions and restore physiological and psychological homeostasis.
How Crying Becomes Repressed
Most parents desperately and understandably want their babies to be
"happy." Thus, those who do not understand the beneficial aspects of crying
may feel anxious or incompetent when their baby cries inconsolably. Some
parents interpret the crying as rejection and conclude that the baby does
not want to be held. Furthermore, few parents were allowed to express their
own pain when they were young, so an infant’s cry cannot help but trigger
their own repressed grief, anger, or fear.
Because of these feelings, there are numerous methods used to repress
crying in infants, which are passed on from generation to generation. If
the parents were distracted from their own attempts to cry as infants or
if they were ignored or punished for crying, there will understandably
be a strong urge to repress their own infant’s crying in similar ways.
Some methods—such as ignoring a crying infant, or hitting, shaking,
or yelling—stem from the parents’ feelings of frustration and utter helplessness.
Other methods appear to be more humane, such as rocking, jiggling, bouncing,
using pacifiers, nursing frequently purely for "comfort" (rather than for
hunger), or attempting to distract the infant with talking, singing, toys,
and so on. However, most of these techniques serve only to postpone the
crying by temporarily distracting the infant, thereby interfering with
the natural tension-release mechanism. The use of all of these distracters
reflects parental anxiety and discomfort with uninhibited emotional expression.
The practice of drugging crying infants has been carried out for
centuries. In the past, in Europe, parents routinely gave alcohol or opium
to their infants to get them to stop crying and go to sleep, and wet-nurses
commonly smeared their nipples with opiate drugs so the baby would sleep.
Popular preparations containing opium were readily obtained from pharmacists
under the names of Laudanum and Paregoric. Many infants became addicted,
while others died from overdoses (Kitzinger, 1989).
Crying infants are frequently drugged nowadays as well. One survey
in England found that twenty-five percent of babies had been given sedatives
by the time they were eighteen months old (Kitzinger, 1989). Parents who
are themselves addicted to chemical substances would be tempted to use
this method to stop their baby’s cries. Unfortunately, these drugs interfere
with a vital healing mechanism and often make the babies lethargic and
unresponsive. Furthermore, babies given sedatives for crying may be at
high risk for drug abuse as teenagers and adults. When children’s very
first attempts to release their painful feelings are repressed with powerful
drugs, it would not be surprising if they turned to drugs later on in life
in order to cope with their feelings.
Support For Parents
To summarize, crying serves a dual purpose during infancy. A primary
function of crying is to communicate vital and basic needs during the preverbal
years. The second function has been largely unrecognized until recently.
Research has shown that crying is a beneficial physiological process that
plays a central role in the resolution of trauma and the restoration of
homeostasis. Once all immediate needs have been met and all medical problems
ruled out, crying infants should be held and allowed to cry as much as
needed.
Since birth-traumatized infants tend to cry more than those not traumatized
and since excessive crying by infants is a potent trigger for child abuse,
it can be concluded that birth trauma is an important factor contributing
to child abuse. In addition to suffering from the birth trauma itself,
these babies often suffer further trauma at the hands of their parents
who do not understand their attempts to heal themselves through crying.
This fact may help to account for the emotional and behavioral problems,
as well as later violent behavior of children who experienced perinatal
complications.
Because of the strong reactions commonly felt by parents of crying
babies, I personally consider all babies who cry extensively to be at risk
for child abuse. I have been working with parents for the past seventeen
years, and I have found that parents of crying babies need four different
kinds of help and support:
First, they need information and continual reminders that the crying
is beneficial and healing for their baby and that their babies’ crying
does not imply that they are inadequate or that their baby is rejecting
them. Second, they need encouragement to hold and listen to their crying
baby. Third, they themselves need to be listened to and allowed to express
their own strong emotions that are triggered by their babies’ crying, as
well as their feelings of anger, anxiety, and powerlessness resulting from
a traumatic pregnancy or delivery. Finally, they need an occasional respite
from parenting responsibilities.
When all parents are receiving this kind of support and information
about crying, then I strongly suspect that we will see a dramatic reduction
in the number of instances of child abuse. Furthermore, the lifelong impact
of traumatic birth will be minimized because babies will be healing themselves
in a supportive environment.
I would like to conclude with a quote from a psychotherapist by the
name of Mark Alter (1981). This is the advice that he wishes he had had
as a new father. It was printed as part of an article by him in Mothering
magazine.
When Greta begins to cry, you will begin to go crazy inside.
You will feel suddenly tight, contracted, unable to breathe . . . and you’ll
feel like screaming, "Shut up! I can’t stand it. Stop your crying or I’ll
kill you." You will feel ashamed of this craziness, but it is not your
fault. It is the craziness of a culture that is terrified of human feeling,
especially crying, and has no idea what to do with it except shut it up.
It is the craziness of your mother and your father and your sister and
the lady who lived downstairs as they stood over your crib, their arms
folded across their chests and their faces looking down at you crying.
The scream that is in you when Greta cries is the scream that was in them
when you cried. No one is to blame for that scream. And when your peace
returns to you, open up the space for your daughter to cry in. Go to her
and hold her. Be at peace and be with her. With your peace and your love
make the space bigger and bigger for her to cry in. Surround her with the
quiet expanse of your eyes and face and body and energy. It will feel like
permission and safety to her. . . . In that space she will cry, for a moment
or for many moments, and in that space she will stop crying. In that expanding
space a miracle will happen to both of you.
Note: Click on book title or its cover
icon for more info on book or reference, including how to purchase.
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Copyright © 1996 by Aletha Solter
1.
This article was originally published in Primal
Renaissance: The Journal of Primal Psychology, Vol. 2, No. 1, Spring
1996, pp. 27-35. Reprinted here, with permission. It had been
presented at the Seventh International Congress of the Association for
Pre- and Perinatal Psychology and Health (APPAH) on "Birth and Violence,"
which was held in San Francisco from September 28th through October 1st,
1995. It was delivered on 29 September 1995. Some of this information
was previously published in the Pre- and Perinatal Psychology Journal,
10(1), 21-43, under the title "Why Do Babies Cry?" [return
to text]
ALETHA SOLTER, Ph.D., is a developmental psychologist and the mother
of two children. Her three books, The Aware Baby, Helping Young
Children Flourish, and Tears and Tantrums have been translated
into several languages. She studied with the Swiss psychologist, Jean Piaget,
at the University of Geneva, Switzerland, where she obtained a Master’s
degree in human biology. She holds a Ph.D. in psychology from the University
of California. Aletha has been working with parents since 1978 and has
given talks and led workshops in eight countries. She lives near Santa
Barbara, California, where she teaches classes based on her work. She also
does private consultations with parents and is the founder of The Aware
Parenting Institute. Her goal is to help create a nonviolent world in which
all children are allowed to attain their full potential. She feels that
parents deserve adequate recognition and support for the challenging job
of raising children. Her work offers parents vital information, as well
as tools for coping effectively with their own strong emotions and those
of their children. Address all correspondence to her at The
Aware Parenting Institute, P.O. Box 206, Goleta, CA 93116 (e-mail:
solter@awareparenting.com).
Websites of interest regarding Aletha Solter's work, Pre- and Perinatal
Psychology, and Healthy Parenting include,
Aletha Solter's The Aware Parenting
Institute site: at www.awareparenting.com
Dr. Solter's site contains information on ordering her books, along with
additional articles and information on her work, links to healthy parenting,
and much more.
The Association for Pre- and Perinatal Psychology and Health site:
at www.birthpsychology.com
The Institute for Psychohistory site also contains information on ways
of healthy parenting and on combating child abuse: at www.psychohistory.com
Primal Spirit Five-Star Recommendations:
Tears and Tantrums: What To Do When Babies and Children
Cry
The Aware Baby: A New Approach to Parenting
Helping Young Children Flourish
Go to Primal Spirit BookStore
Related Article: Go to "Ending
Circumcision: Where Sex and Violence First Meet" by Jeannine
Parvati Baker.
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