What is Abreaction?

How Abreaction Relates to Dissociation and Trauma

U.S. War Veteran And Family Cope With Post Traumatic Stress Disorder. John Moore / GettyImages

An abreaction is an emotional, unconscious reaction that you have in response to a stimulus that brings back a painful situation you have experienced before. It may be from an event that you remember, or it may be something that suddenly pops into your consciousness when having the abreaction. 

Understanding Abreaction

As an example, consider someone who has been physically abused who responds to a raised hand by cringing even though the other person's intent was to brush away a stray thread.

Abreaction can also be used to describe the process a therapist uses to desensitize or help a patient to stop having these automatic reactions. Within the safety of a therapy session, a patient may be led to experience abreaction and can then learn to replace the illogical, gut-instinct reaction with one that is more suited to the situation.

History of Abreaction in Therapy

Abreaction, along with its counterpart catharsis, which refers to emotional release, were first discussed at length by Sigmund Freud and Josef Breuer in their early studies on psychoanalysis.They put a significant amount of emphasis on the importance of the abreaction and catharsis, but after more study, they realized that simply expressing and/or reliving painful emotions is not all that is needed to achieve recovery, particularly for trauma survivors.

This emphasis on achieving catharsis through abreaction carried on through World Wars I and II through trauma therapists who used hypnosis and chemically-induced techniques to create abreactions.

Some did realize the importance of helping trauma survivors do more than just deal with their emotions. 

Abreaction and Dissociation

Trauma often causes people to dissociate from their emotions, memories and/or identity. The amount of dissociation a person experiences can range from mild, similar to daydreaming, to severe, as in the case of people with multiple personalities.

Freud's initial belief in promoting an abreaction in therapy was that through the release of the painful emotions, the traumatic experience would be dealt with.

The problem is, abreaction, in this case the expressing of emotions, by itself does not cure anything. Many people can experience their emotions or relive the traumatic events over and over, but nothing is ultimately solved. Especially for sufferers of trauma, there is often still some amount of dissociation involved and some schools of thought believe the dissociation needs to be dealt with as well by making it part of the person's consciousness and identity.

We know today that dealing with traumatic stress such as post-traumatic stress disorder (PTSD) cannot rely just on treating the traumatic memories with abreaction or any other method. In fact, studies have shown that the best kind of therapy for PTSD is cognitive-behavioral therapy (CBT) which has nothing to do with abreaction.

Cognitive-Behavioral Therapy for Post-Traumatic Stress Disorder

CBT works because it helps PTSD survivors reframe their thinking about their trauma.

For instance, a rape survivor may feel illogical and unnecessary guilt for putting herself in what she perceives as a bad situation. With CBT, she would learn to change her thinking to realize that it doesn't matter what situation she was in, only rapists rape and she could learn to let go of the guilt. 

Changing faulty thinking and replacing it with more rational, factual thinking instead helps PTSD survivors cope better with the feelings of guilt, anger, distress and fear they may be feeling.

Sources:

"Dissociation and Dissociative Disorders." Mental Health America (2016).

van der Hart, O. and Brown, P. "Abreaction Re-evaluated." Dissociation 5 (3), 1992.

"Treatment of PTSD." U.S. Department of Veterans Affairs (2016).

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