The psychological phenomena that hypnotherapists either love or hate
Of all the phenomena encountered by the working hypnotherapist - or stage hypnotist, for that matter - the abreaction is probably the least understood. Or the most MISunderstood. The first encounter the therapist has with this process of the mind is inclined to polarise him/her and from that moment on s/he will either seek to avoid it like the plague or search it out with a determination that is at least equal to the client's resistance.
It's the type of training we receive that governs this response; analysts are delighted by abreaction, live (in the therapeutic sense) for abreaction, and firmly believe that it provides the fastest and most profound relief from all manner of psychological symptoms. Others may be less certain of this, viewing this sudden intensely emotional state with alarm, and frantically searching for ways to calm down what their administrations have disturbed. All therapists should have a clear idea of what is actually happening, and should also understand a Very Important Fact - abreaction, handled properly, can do only good for your client. I have worked with the abreactive state in therapy for a good many years now, seeing 30 a clients a week for most of that time, and can promise you that there is nothing to fear from it, as dramatic and traumatic as it can appear to be. It cannot cause your client lasting harm and it cannot leave them worse off than before they came to you, no matter what you might read to the contrary, as long the process is completed.
So what exactly is it and how do we handle it? As for what it is, it is the revivication of a traumatic experience that occurred in a moment of great trauma - usually, though not exclusively, during our formative years. In other words, the release of a repression. An adult repression can occur as a result of, say, a traumatic road accident, when we then tend to call it amnesia, instead.
There can be three separate, though intimately connected, memories involved with any form of repression. The perception of the event (usually visual); the physical sensations; and the emotional response. And, yes, they ARE entirely separate memories and each may 'surface' together or individually.
It is not unusual for a client to recall, in one session, a physical sensation of some sort so strongly that s/he can actually FEEL it, yet not discover the emotional response or the exact nature of the event until their next session or even the one after that. It is the emotional part of any abreaction (often unwarranted guilt, shame, or vulnerability) that is the most important and once this has been 'surfaced' and worked through, it is likely that the client will display little or no interest in further investigation of that particular memory. It is not uncommon, in fact, for the emotion to be released without ever discovering what was the cause of it; this appears to matter little, for catharsis will still be effected and symptoms still alleviated.
This revivication can be so realistic, as far as the client is concerned, that their body will actually reproduce the physical changes that occurred at the time of the event; if there was an element of suffocation, for example, your client may suddenly find great difficulty breathing - or may even stop breathing for a few moments. If they were physically abused in some way, then they may well feel that same abuse - or the results of it - whilst in your chair, just as if it were happening to them right at that very moment. I have seen finger marks appear where a slap on the face has been recalled. There is no mystery here, simply the autonomic system perceiving pain and reacting by increasing blood supply to the area to heel effect any repair that is necessary. A client may scream, shout, sob, sweat, shake violently, curl up into a foetus, gag... it can be a truly unnerving experience for the unwary! But all the therapist has to do is make sure that they 'go for it' whole-heartedly. Urge them on through it, though being VERY careful only to guide and not lead (my last two articles on this page will help with this*). Sound confident and BE confident. Tell them to 'just be there in your mind'. Urge them to 'stay with it - give it room in your body'.
DO NOT TOUCH THEM - UNLESS YOU WANT TO BECOME PART OF THE TRAUMA.
Not only that, it may distract them from the job in hand and they need no comforting hand right now, anyway. Something wonderful is happening; they are setting themselves free from a prison of their mind's making and their life is going to change immeasurably for the better over the next few months.
It can be difficult, for the caring individual, to sit and watch this event that is so evidently full of pain unfolding in front of them, but once you have experienced the sense of lightness and relief that a client can manifest immediately after the abreaction has subsided, you will have no more problem with that. It is not fair to say that all their symptoms will disappear overnight, but from that cathartic moment onwards, your client will start to FEEL well and his/her symptomatic work will very soon start to fade. Usually, you and your client will have an understanding of why the event that has been remembered should have caused their symptoms. If not, it always possible that there is something else to be released but, this time, it is likely to be less intense.
There is something of immense importance when working with abreactive states and that is to make ABSOLUTELY CERTAIN that your client had accessed the emotional 'roots' of their psychological difficulty. It is the ORIGINATING CAUSE OF TRAUMA (often called the Initial Sensitising Event, or ISE) that we are after and nothing else will do. It is actually quite easy to ascertain whether they have been to the right place or not... if the emotional response does not start to fade within a few minutes, or if it returns to its former strength each time the memory is accessed, then there is still work to do. Work backwards from that memory using either direct regression or free associative techniques to an earlier memory with the same or similar emotional qualities and work through that one in the way you have just been reading about. Keep going until the negative emotion has cleared and cannot be restored. The client is then well on the road to sound emotional health.
Mostly, abreaction of the sort discussed in this article appears as the result of regression-style therapies, but it can also happen spontaneously. Even then, the rules are the same - work through it and make sure you've got it all out.
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