Thursday, January 5, 2012

The Science of "Crying It Out"?

Somewhat recently, I read an article titled, Dangers of "Crying It Out". Of course it resonated with much of what I already believe, which made it a good read. We all like to know we're right. However, I cannot undo seven years of learning to critically evaluate information. I had to dig deeper than a Psychology Today blog post.

I read through the References section and found a full PDF was available of Schore's article, The effects of early relational trauma on right brain development, affect regulation, and infant mental health. This was published in 2001 in a peer-reviewed journal by a UCLA professor. The following paragraphs are excerpts related to allowing babies to cry themselves to sleep.

In an immature organism with undeveloped and restricted coping capacities, the primary caregiver is the source of the infant’s stress regulation, and therefore, sense of safety. ...  The infant’s immature brain is in a state of rapid development, and is, therefore, exquisitely vulnerable to early adverse experiences, including adverse social experiences. ... There is extensive evidence that trauma in early life impairs the development of the capacities of maintaining interpersonal relationships, coping with stressful stimuli, and regulating emotion. ...

In contexts of relational trauma the caregiver, in addition to dysregulating the infant, withdraws any repair functions, leaving the infant for long periods in an intensely disruptive psychobiological state that is beyond her immature coping strategies. ...

In the initial stage of threat, a startle or alarm reaction is initiated, in which the sympathetic component of the autonomic nervous system (ANS) is suddenly and significantly activated, resulting in increased heart rate, blood pressure, respiration, and muscle tone, as well as hypervigilance. Distress is expressed in crying and then screaming. [emphasis mine]

In very recent work, this dyadic transaction is described by Beebe as “mutually escalating base of text overarousal” of a disorganized attachment pair:

Each one escalates the ante, as the infant builds to a frantic distress, may scream, and, in this example, finally throws up. In an escalating overarousal pattern, even after extreme distress signals from the infant, such as ninety-degree head aversion, arching away . . . or screaming, the mother keeps going. (2000, p. 436) ... [emphasis mine]

But Perry’s group describes a second, later-forming reaction to infant trauma, dissociation, in which the child disengages from stimuli in the external world and an attends to an “internal” world. The child’s dissociation in the midst of terror involves numbing, avoidance, compliance, and restricted affect. Traumatized infants are observed to be staring off into space with a glazed look. This behavioral strategy is described by Tronick and Weinberg:

[W]hen infants’ attempts fail to repair the interaction infants often lose postural control, withdraw, and self-comfort. The disengagement is profound even with this short disruption of the mutual regulatory process and break in intersubjectivity. The infant’s reaction is reminiscent of the withdrawal of Harlow’s isolated monkey or of the infants in institutions observed by Bowlby and Spitz. (1997, p. 66) [emphasis mine]

The state of conservation-withdrawal (Kaufman & Rosenblum, 1967, 1969; Schore, 1994) is a parsympathetic regulatory strategy that occurs in helpless and hopeless stressful situations in which the individual becomes inhibited, and strives to avoid attention in order to become “unseen.” ... If early trauma is experienced as “psychic catastrophe” (Bion, 1962), dissociation represents “detachment from an unbearable situation” (Mollon, 1996), “the escape when there is no escape” (Putnam, 1997), and “a last resort defensive strategy” (Dixon, 1998).

Proponents of the "cry-it-out" method point out that children eventually learn. They stop screaming and go calmly into their cribs. They have learned to self-soothe, a step toward independence. I am not confident that it is child abuse to leave an infant to cry it out; perhaps the cited research was done with children experiencing much more trauma. But the pattern of crying, screaming, and then withdrawing quietly and self-comforting sounds very similar to what I've heard from supporters of crying it out. Food for thought.


  1. Wow. That's interesting that one reference likens a baby who has cried it out to Harlow's monkey. It is sad that one of the children in the study cried so hard that he or she threw up. This makes sense. It just makes sense to me that when babies are looking for comfort and don't get it, they have to withdraw in order to deal with their emotion. And yes, then they "learn." That no one comes when they cry. That is sad to me.

    It's not to say I haven't had moments in the middle of the night where Little M was inconsolable and I was exhausted and I let him cry. I've had my shameful mommy moments. But I wouldn't do it as a matter of practice, just as a matter of desperation. (And I even hate to admit that.)

  2. @Gaby: Sometimes it is safer to let your little one cry than to risk losing your patience or not being able to keep him safe because you are exhausted. I think we all need to learn to be as gentle with ourselves as we are with our children. Every day is a new morning!