by Bruce Wilson
Looking at the state of psychotherapy today, one might be forgiven for thinking that it’s always been about talking, analysis, and cognition. Psychoanalysis is focused on…well…analysis—examination, interpretation, and explanation with words upon words upon words, but it wasn’t always that way.
Before there was psychoanalysis, there was “cathartic therapy.” Freud and Breuer experimented with catharsis after being influenced by German philosopher, Jakob Bernays, who advocated Aristotelian catharsis in medical treatment. They called it abreaction — “to react away or to react off…. the act of giving vent in speech and action to repressed experiences, and thereby disburdening one’s self of their unconscious influences.”
Even in those early years, one can see the bias towards talk therapy rather than connected feelings. In Studies on Hysteria, Freud and Breuer write, “language serves as a substitute for action; by its help, an affect can be ‘abreacted’ almost as effectively.” Eventually, psychoanalysis abandoned catharsis. The expression of feelings was never a central theme in analysis; at most, it was considered as a tool to loosen “strangulated affect” and facilitate analysis and it was usually done under hypnosis.
The “discharge” theme is also evident in the work of French psychiatrist, Pierre Janet (1859-1947), who used the colourful name of “mental liquidation” for abreaction. Janet regarded neurosis somewhat like an electrical capacitor—traumatic memories were stored as “mental energy” or “psychological tension” and abreaction was the means to release it. Several other European physicians used catharsis in the late 19th and early 20th centuries, either with or without hypnosis, and some achieved significant success. Dutch physician, Andries Hoek (1807-1885) reports the use of catharsis on a psychotic patient who was terribly tramatized by repeated childhood abuse, including rape, and by the death of her ex-fiancé, who killed himself after she broke off the engagment. Over an 11-month period of daily sessions, his patient achieved sanity. Most remarkable was that Hoek allowed his patient to take an active role in treatment and guide its course. This in itself may have been the reason why his patient got better. Having a sympathetic witness can do wonders to help someone heal, although it is not enough.
Abreaction was used by several 20th Century psychologists, especially for traumatized soldiers in the two World Wars, however, the purgation aspect increasingly came to dominate. Although the emphasis had originally been on reliving the traumatic memory, as we see in primal therapy, therapists encouraged emotional venting as a way to clear the decks for what they regarded as the real work: talk therapy. The focus shifted toward controlling emotions rather than finding resolution through their expression. Ernst Simmel, a German medical officer in WWII, regarded catharsis as an opportunity for the soldier to “master his emotions intellectually.”
After the war, emotional expression in psychotherapy became more mechanized and increasingly detached from the patient’s inner being. Psychodrama treated feelings as a sort of stage play that one could act out. (Don’t neurotics have enough acting out?) Reich had his patients access “simulated” feelings through a bizarre process he called vegetotherapy, in which:
…the analyst [asks] the patient to physically simulate the bodily effects of strong emotions. The principal technique is asking the patient to remove outer clothing, lie down on a sheet-covered bed in the doctor’s office, and breathe deeply and rhythmically. An additional technique is to palpate or tickle areas of muscular tension (“body armor”). This activity and stimulation eventually causes the patient to experience the simulated emotions, thus (theoretically) releasing emotions pent up inside both the body and the psyche…. Screaming usually occurs, and vomiting can occur in some patients.
Reich later developed this process into orgone therapy. The intent was to free up orgone energy and make it available for more useful purposes, such as orgasm. Alexander Lowen refined Reich’s therapy into Bioenergetics which again focused on body “energy” rather than integrated feeling. One sees this focus on the body in Pat Ogden’s Sensorimotor therapy, in which traumatic memories and feelings have been reduced to mere physical sensations. (I’ve viewed videos of Ogden’s approach and they are excruciating to watch. So close to feeling and yet so far!)
Fritz Perls’s Gestalt Therapy utilized emotional expression but the patient was kept firmly in the present. One of the more bizarre uses of abreaction was in Danriel Casriel’s New Identity Process, which utilized screaming as an “an emotional exercise that frees the individual from symptomatic pain and leads to the deeper feelings he has disguised.” His aim was to “re-educate” the patient’s emotions, behaviors, and attitudes. His book, “A Scream Away from Happiness” says it all.
This short history reveals clearly why abreaction was abandoned and especially why it’s regarded with such disdain today. Despite the promising beginnings of the deep feeling approach, psychoanalysis was never able to get a handle on feelings as feelings. The psychoanalyst lives in the left hemisphere and even though there may be deep intellectual understanding of how the right hemisphere processes feelings, it’s not the same as knowing it from the inside. Allan Schore comes to mind. Despite his brilliant work on early life attachment, emotional dysregulation, and the role of the right brain, his work exudes the dry, detached intellectuality of all psychoanalysts. His therapeutic approach remains firmly embedded in psychoanalysis with the therapist in full control.
Without the understanding of how deep feelings actually work, without knowing them from the inside, one is led into a desert of ideas about feeling, some of which are quite bizarre. Abreaction, that is venting, purging, screaming, expunging, or mere expression of feelings without connection and integration is not only nontherapeutic, it is dangerous. This is undoubtedly why most psychologists reject deep feeling approaches on the grounds that they are “retraumatizing.” Dredging up feelings without a clear understanding of what’s going on is a recipe for disaster.
In my next post, I’ll discuss the difference between abreaction and primal therapy.
The Abreaction Part I: What it is and why it was abandoned in psychotherapy by The Primal Mind, unless otherwise expressly stated, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 2.5 Canada License.