- “When you’re weary, feelin’ small, When tears are in your eyes, I will dry them all.” [Paul Simon, “Bridge Over Troubled Waters”]
- “When you’re down and troubled / And you need a helping hand, / And nothing, nothing is going right, / Close your eyes and think of me / And soon I will be there, / To brighten up even your darkest night.” [James Taylor, “You’ve Got a Friend”]
When we are upset, we may not function well, not to mention that emotional upset is unpleasant, even terrifying. Emotional upset disrupts eating, learning, working, social functioning, and a wide array of essential life functions. (See the Technical and Analytical Readings section below for the technical literature supporting these and the following statements.)
Receiving emotional comfort tells us that others care about us, and thereby reinforces a message that we should feel good about ourselves. A simple physical touch, a bit of listening, and a little companionship can calm and reassure.
Doctors and nurses routinely employ comforting behaviors and strategies with their patients. Non-human animals are well-known sources of comfort, as are music and visual images. The human response to comforting appears to be innate, as comforting behaviors are effective with newborn babies. The mere remembrance of a deceased loved one can provide comfort to the bereaved. Self-comforting strategies are also important.
Comforting and self-comforting are especially important in times of illness, bereavement and long, dark winters. However, comfort-seeking can have deleterious effects, for example, in addictions.
Comforting and self-comforting are impaired by anxiety and depression. Anxiety in a mother interferes with a baby’s ability to self-comfort. In fact, parents’ reactions and responses to children’s expressed emotions have been shown to affect comforting and other behaviors in children.
We have a substantial body of professional and scientific literature on the effects of comforting. However, people were comforting themselves and others long before psychology became a recognized discipline. One person’s sense of what would comfort him enables him to comfort someone else. However, caution is advised: a word or gesture meant to comfort another person may have the opposite effect. Being around someone who is suffering is unpleasant, so we may seek to end our own suffering, insensitive to the suffering of the other. Through understanding, empathy and wisdom – all subjects that we will explore in this book – we can put aside our egos and truly comfort others.
Technical and Analytical Readings
By consensus, psychologists recognize eating disorders as a form of mental illness, listing them in the Diagnostic and Statistic Manual of Mental Disorders (DSM-5).
- Pamela K. Keel, Eating Disorders (Oxford University Press, 2nd edition, 2016).
- Philip S. Mehler and Arnold E. Anderson, Eating Disorders: A Guide to Medical Care and Complications (Johns Hopkins University Press, 2nd edition, 2010).
- Glenn Waller, et. al., Cognitive Behavioral Therapy for Eating Disorders: A Comprehensive Treatment Guide (Cambridge University Press, 2007).
- Rowsell, D.E. MacDonald and J.C. Carter, “Emotion regulation difficulties in anorexia nervosa: associations with improvements in eating psychopathology”, Journal of Eating Disorders. 2016 May 18;4:17.
- Ruscetti, K. Rufino, N. Goodwin and R. Wagner, “Difficulties in emotion regulation in patients with eating disorders”, Borderline Personality Disorder and Emotional Dysregulation. 2016 Jun 1;3:3.
Emotional dysfunction and learning:
- Joan E. Sieber, Harold F. O’Neil, Jr., and Sigmund Tobias, Anxiety, Learning, and Instruction (Routledge, 1977).
- Shi and P. Liu, “Worrying Thoughts Limit Working Memory Capacity in Math Anxiety”, PLoS One. 2016 Oct 27;11(10):e0165644.
- Nicholas A. Hubbard, Joanna L. Hutchinson, D. Zachary Hambrick and Bart Rypma, “The enduring effects of depressive thoughts on working memory”, Journal of Affective Disorders, 2016, 190: 208–213.
Emotional dysfunction and work:
- A. Adler, T.J. McLaughlin, W.H. Rogers, et al., “Job Performance Deficits Due to Depression”, American Journal of Psychiatry. 2006;163(9):1569–1576.
- Tomonaga, J. Haettenschwiler, M. Hatzinger M, et al., “The Economic Burden of Depression in Switzerland”, Pharmacoeconomics, 2013;31(3): 237-250.
- A.M. Roelen, G. Norder, P.C. Koopmans, et al., “Employees Sick-Listed with Mental Disorders: Who Returns to Work and When?” Journal of Occupational Rehabilitation, 2012;22(3):409–417.
Emotional dysfunction and social functioning:
- M.A. Hirschfeld, S.A. Montgomery, M.D. Keller, et al. “Social functioning in depression: A review”, Journal of Clinical Psychiatry. 2000;61(4):268–275.
- Radanović-Grgurić, et. al., “The impact of displacement on the expression of depressive disorderand social functioning among the war refugees”, Psychiatria Danubina: 2009 Dec;21(4):474-82.
- S. Lee, A.E. Falk and V.P. Aguirre, “Association of comorbid anxiety with social functioning in school-age children with and without attention-deficit/hyperactivity disorder (ADHD)”, Psychiatry Research: 2012;197:90–96.
- P. Becker, et. al., “Differentiating Anxiety and Depression in Relation to the Social Functioning of Young Adolescents With ADHD”, Journal of Clinical Child and Adolescent Psychology: 2015;44(6):1015-29.
- Susan Nolen-Hoeksema and Lori M. Hilt., eds., Handbook of Depression in Adolescents (Routledge, 2008).
- John R. Z. Abela and Benjamin L. Hankin, eds., Handbook of Depression in Children and Adolescents (The Guillford Press, 2007).
- H. Lin, Y.C. Yen, M.C. Chen and C.C. Chen, “Depression and pain impair daily functioning and quality of life in patients with major depressive disorder”, Journal of Affective Disorders: 2014 Sep;166:173-8.
- Martin M. Anthony and Murray B. Stein, Oxford Handbook of Anxiety and Related Disorders (Oxford University Press, 2009).
- Robert J. Blanchard, D. Caroline Blanchard, Guy Griebel and David J. Nutt, eds., Handbook of Anxiety and Fear (Academic Press, 2008).
- Dean McKay and Eric A. Storch, eds., Handbook of Childhood and Adolescent Anxiety Disorders (Springer, 2011).
Touch-based interventions, and the importance of touch:
- Matthew J. Hertenstein and Sandra J. Weiss, eds., The Handbook of Touch: Neuroscience, Behavioral and Health Perspectives (Springer, 2011).
- Case-Smith, “Systematic review of interventions to promote social-emotional development in young children with or at risk for disability”, American Journal of Occupational Therapy: 2013 Jul-Aug;67(4):395-404.
- Cynthia Price, “Body-Oriented Therapy in Recovery from Child Sexual Abuse: An Efficacy Study”, Alternative Therapies in Health and Medicine: 2005; 11(5): 46–57.
- Weller and R. Feldman, “Emotion regulation and touch in infants: the role of cholecystokinin and opioids”, Peptides: 2003 May;24(5):779-88.
The therapeutic value of listening:
- David Welch, The Therapeutic Relationship: Listening and Responding in a Multicultural World (Praeger, 2009).
The importance of companionship:
- N. Cavallo, et. al., “The role of companionship, esteem, and informational support in explaining physical activity among young women in an online social network intervention”, Journal of Behavioral Medicine: 2014 Oct;37(5):955-66.
- A. van Orden, et. al., “The Senior Connection: design and rationale of a randomized trial of peer companionship to reduce suicide risk in later life”, Contemporary Clinical Trials: 2013 May;35(1):117-26.
- Amelia R. Turagebeci, et. al., “Family structure and health, how companionship acts as a buffer against ill health”, Health and Quality of Life Outcomes: 2007 Nov 23;5:61.
Doctors comforting patients:
- Richard Dew, “Comforting a grieving patient”, American Family Physician, 2011 Jan 1;83(1):79-80.
Nurses comforting patients:
- P. Hawley, “Nurse Comforting Strategies: perceptions of emergency department patients”, Clinical Nursing Research, 2000 Nov;9(4):441-59.
- Penrod, J.M. Morse and S. Wilson, “Comforting strategies used during nasogastric tube insertion”, Journal of Clinical Nursing, 1999 Jan;8(1):31-8.
- M. Morse, G.A. Havens and S. Wilson, “The comforting interaction: developing a model of nurse-patient relationship”, Scholarly Inquiry for Nursing Practice, 1997 Winter;11(4):321-43; dscussion 345-7.
- J. Walters, “The comforting role in critical care nursing practice: a phenomenological interpretation”, International Journal of Nursing Studies, 1994 Dec;31(6):607-16.
- S. Acebedo-Urdiales, J.L. Medina-Noya and C. Ferré-Grau, “Practical knowledge of experienced nurses in critical care: a qualitative study of their narratives”, BMC Medical Education, 2014 Aug 18;14:173.
The role of non-human animals in comforting people:
- A. Marcus, “The science behind animal-assisted therapy”, Current Pain and Headache Reports, 2013 Apr;17(4):322.
- S. Patterson, et. al. “Implementing music therapy on an adolescent inpatient unit: a mixed-methods evaluation of acceptability, experience of participation and perceived impact”, Australasian Psychiatry, 2015 Oct;23(5):556-60.
- See: Michael H. Thaut and Volker Hoemberg, eds., Handbook of Music Therapy (Oxford University Press, 2014).
Use of painting and photographs in comforting:
- Mander and R.K Marshall, “An historical analysis of the role of paintings and photographs in comforting bereaved patients”, Midwifery, 2003 September; 19(3): 230-42.
- M. Morse, S.M. Solberg and J. Edwards, “Caregiver-infant interaction – comforting post-operative neonates”, Scandanavian Journal of Caring Sciences, 1993;7(2):105-111.
- H. Atkinson, et. al., “Caregiver Emotional Availability, Caregiver Soothing Behaviors, and Infant Pain During Immunization”, Journal of Pediatric Psychology, 2015 Nov-Dec;40(10):1105-14.
Comforting the bereaved:
- L. Foster, et. al., “Comparison of continuing bonds reported by parents and siblings after a child's death from cancer”, Death Studies, 2011 May-Jun;35(5):420-40.
- D. Kunkel and M.R. Dennis, “Grief consolation in eulogy rhetoric: an integrative framework”, Death Studies, 2003 Jan;27(1):1-38.
- C. Horton, “Self-comforting strategies used by adolescents”, Bulletin of the Menninger Clinic, 2002 Summer 66(3): 259-72.
- Dahlqvist, A. Söderberg and A. Norberg, “Dealing with stress: patterns of self-comfort among healthcare students”, Nurse Education Today, 2008 May;28(4):476-84.
Comforting the ill and their loved ones:
- Rani Liu, et. al., “Coping styles and disability in patients with hand osteoarthritis”, Rheumatology, 2016 Mar;55(3):411-8.
- Havermans, et. al., “Breaking bad news, the diagnosis of cystic fibrosis in childhood”, Journal of Cystic Fibrosis, 2015 Jul;14(4):540-6.
Comforting during life’s long, dark winters:
- Wiens, H. Kyngäs and T. Pölkki, “The meaning of seasonal changes, nature, and animals for adolescent girls' wellbeing in northern Finland: A qualitative descriptive study”, International Journal of Qualitative Studies on Health and Well-being, 2016 Feb 22;11:30160.
Comforting and addictions:
- L. Parylak, G.F. Goob and E.P. Zorrilla, “The dark side of food addiction”, Physiology and Behavior, 2011 Jul 25;104(1):149-56.
Anxiety and depression in the caregiver:
- E. Kircher, “Anxiety”, Emergency Medicine Clinics of North America, 1991 Feb;9(1):161-87.
- A. Macrae, et. al., “The impact of depression on maternal responses to infant faces in pregnancy”, Infant Mental Health Journal, 2015 Nov-Dec;36(6):588-98.
- Müller, et. al., “Effects of Maternal Anxiety Disorders on Infant Self-Comforting Behaviors: The Role of Maternal Bonding, Infant Gender and Age”, Psychopathology, 2016;49(4):295-304.
Difficulties in encountering others’ suffering:
- Eisenberg, R.A. Fabes and B.C. Murphy, “Parents’ reactions to children’s negative emotions: relations to children’s social competence and comforting behavior”, Child Development, 1996 Oct;67(5):2227-47.
- Savulescu, B. Foddy and J. Rogers, “What should we say?”, Journal of Medical Ethics, 2006 Jan; 32(1): 7–12.
- Diego Rivera, The Embrace (1923)
Music: songs and other short pieces
- Simon & Garfunkel, Bridge Over Troubled Water
- Peter, Paul and Mary, Day Is Done
- Janis Ian, Phoebe Snow and Odetta, Hymn
- Sara Gazarek, “And So It Goes”
- Johann Sebastian Bach, Solo Cello Suite No. 1 in G Major, bwv 1007: (4) Sarabande
- Johann Sebastian Bach, Solo Cello Suite No. 2 in D minor, bwv 1008: (4) Sarabande
- Johann Sebastian Bach, Solo Cello Suite No. 3 in C Major, bwv 1009: (4) Sarabande
- Johann Sebastian Bach, Solo Cello Suite No. 4 in E-flat Major, bwv 1010: (4) Sarabande
- Johann Sebastian Bach, Solo Cello Suite No. 5 in C minor, bwv 1011: (1) Prelude, (2) Allemande
- Ledger, My Arms
- Sarah Winman, When God Was a Rabbit: A Novel (Bloomsbury, 2011). “’If this God couldn’t love me,’ she resolves, ‘then it was clear I’d need to find another one that could.’”
- Alex DiFrancesco, Transmutation: Stories (Seven Stories Press, 2021): “At the affective core of ‘Transmutation’ is the question of how we can offer shelter for one another’s pain, real and imagined.”
Open these links for lists of children’s books meant to comfort children.
From the dark side:
In Kafka’s The Metamorphosis (1915), a member of the family and household has been transformed into a giant insect. While he lived, family members stated openly that they wished he would go away. When he dies, the family is relieved, for themselves.
"Dead?" said Mrs. Samsa, looking questioningly at the cleaning woman, although she could have investigated for herself, indeed the fact was obvious enough without investigation. "I should say so," said the cleaning woman, and to prove it she pushed Gregor's corpse a long way to one side with her broomstick; Mrs. Samsa made a movement as if to stop her, but checked herself. "Well," said Mr. Samsa, "now thanks be to God." He crossed himself, and the three women followed his example.
[Kafka, The Metamorphosis (1915), Part III.]
Music: Composers, artists, and major works
- Barber, Violin Concerto, Op. 14, H94 (1939)
- Korngold. Violin Concerto in D Major, Op. 35 (1945)
- Gouvy, 20 Sérénades for piano (1855)
- Fauré, Violin Sonata No. 2 in E Minor (1917): In declining health and distraught by World War I, Fauré may have sought refuge in the unadorned lines of this sonata.
- Waghalter, Sting Quartet in D major, Op. 3 (ca. 1900)
- Raga Brindabani sarang: Traditionally associated with flute-playig cowherders in Brindaban, this raga is also illustrated by a painting of Vishnu with his conch (performances by Chaurasia, Joshi and Bismillah Khan).
I would in that sweet bosom be
(O sweet it is and fair it is!)
Where no rude wind might visit me.
Because of sad austerities
I would in that sweet bosom be.
I would be ever in that heart
(O soft I knock and soft entreat her!)
Where only peace might be my part.
Austerities were all the sweeter
So I were ever in that heart.
[James Joyce, “I Would in That Sweet Bosom Be”]
- William Wordsworth, “To a Redbreast (In Sickness)”