An abreaction is the reliving of traumatic early life experience
Sometimes abreactions are deliberately evoked. Sometimes they occur spontaneously. They usually involve a total re-experiencing in every detail of an early life trauma. They can often be dramatic and frightening not only for the Patient but also for the therapist.
These traumas have often been repressed and amnesia for the traumas may exist prior to the abreaction
Sometimes people are aware of early traumatic events, sometimes they have forgotten them. Amnesia usually exists when the trauma is so severe that the child blocks out the experience as a way of surviving. This is particularly true in the case of multiple personality. Multiple personality, often caused by abuse, is the experiencing of many sub-personalities caused by continual abuse followed by dissociation from the traumatic experience. The child learns to dissociate from the memory, create an amnesia for the experience, and then when abused the next time to follow the same pattern until a number of personalities exist each with their own unique experience and their own personality. These personalities usually have no knowledge of each other at a conscious level. Once an abreaction has occurred Patients usually remember the event although sometimes a spontaneous amnesia occurs as well.
An abreaction should be carried through to the end
In therapy, therapists work with the raw materials. Emotion is the rawest material a therapist can work with. An abreaction offers the therapist raw materials. If an abreaction starts to occur spontaneously the therapist should encourage it to develop as long as he is confident to handle it. If the abreaction is prevented from occurring it is usually very difficult to access at a later date. The reason for this is that the Patient now has an awareness of a hidden traumatic experience. The Patient is aware that at any time these feelings could overwhelm. Any attempt to evoke the abreaction will usually result in intense resistance to any efforts by the therapist. Once an abreaction does occur is should not be terminated halfway through. This would only leave the work half done. Abreaction should be carried through to the very end. By going through the whole cycle of experience the Patient is able to express the feelings fully. Usually when this is complete the Patient experiences a release of feelings, intense exhaustion, and extreme stress.
An abreaction can be dramatic and the therapist should stay calm throughout
As well as being terrifying for the Patient abreactions can be frightening for the inexperienced therapist. Sometimes Patients may even become violent. This is especially true when the Patient identifies the therapist as a participant in the traumatic experience. If a transference occurs whereby the Patient imagines the therapist to be an active participant in the early life memory the Patient can become aggressive towards the therapist. In these cases the therapist should attempt to protect the Patient and himself. Whenever possible the therapist should remain calm and detached from the experience whilst maintaining control of the situation and support for the Patient as they abreact.
An abreaction can sometimes lead to realisation but rarely resolution
After a Patient has abreacted they will often have new information about the cause of their problem. However knowing why a problem exists doesn’t usually solve it. When Patients abreact they release energy and they free additional energy that previously was used to repress the traumatic memory. This new release of energy can be applied and directed into future positive outcomes. However the release of energy is in itself not a cure.
Patients often feel vulnerable after an abreaction – this is when therapy should occur
At the end of an abreaction the therapist should start to consider various therapeutic approaches to repairing the Patient. At this time more than any other the Patient feels the most vulnerable. To send the Patient home in this state would be criminal. It is very important for the therapist to utilise the Patient’s experience now and reframe it in some way so that the Patient leaves the therapy setting with new beliefs.
Guilty parties/negative experiences/events should be reframed to “heal the memory”
Usually traumatic memories have a cast of characters. In the case of abuse it may be one person. In the case of humiliation, for example a child at school being laughed at, it may be a number of characters. The Patient will usually have intense feelings towards the characters in the trauma. These feelings may be anger, resentment, and maybe even revenge. The feelings that the Patient has are normally negative and aggressive in some way. In a way the Patient is quite justified in feeling this way as they have probably carried around the symptoms caused by this event for most of their life. Sometimes it is positive to allow the Patient to keep these feelings. Usually it is more therapeutic to reframe these feelings in some way. For example a child abused by a parent will feel very angry and resentful yet at the same time want to be loved. The needing to be loved is an important element in Reframing the Patient’s belief and attitude towards the parent.
The parent may be alive or dead, the Patient’s feelings of anger may still be the same. An approach might be that the therapist suggest that the parent had a reason for abusing. Usually the Patient has available to him, information about the parent received unconsciously in childhood. The Patient may even be able to give valid reasons why the parent abused. Bearing in mind the Patient wishes to be loved he may be willing to look at ways of understanding why the parent abused. Maybe the Patient has an awareness that the parent was abused as a child. This might help explain the parent’s behaviour. Leading on from this the therapist may be able to suggest that the Patient think of forgiving the parent. If the Patient wants to be loved and would like to change the negative feelings they have towards the parent then it may be possible to convert the hatred into forgiveness. The Patient would then leave the therapy session having had the emotions evoked by the abreaction, and dealt with positively by the therapist.
Our ‘hypnotherapy skills and tips’ posts have been edited by Dr Andrew Bradfield and Dr Colin Baron from the teachings of BHRTS founder Stephen Brooks.