Monday, July 27, 2015

On the Difference Between Abreaction and Feeling (Part 2/9)


 Taking the Wrong Track into Abreaction

 To understand more about how abreaction works, let’s see what happens when a session goes off track.
 As we now know, there is a critical window during a session when the patient brings in a certain feeling, say, helplessness. If the therapist does not act to help the person delve into the feeling it very well may be too late, later on in the session. When the therapist does not strike at the critical moment, the specific feeling/frequency the patient came in with is now gone. What the patient will be left with is abreaction, the discharge of a secondary feeling, not the key one she brought in. That means no resolution and integration of feeling because the feeling has not been felt. When we measure vital functions after the session, the signs move in sporadic fashion. They do not move in coordinated ways but as though each function moves at a different pace. They seem to have lost their cohesion, which tells us that no primal has occurred.


 What I think may happen, and this is only hypothesis, is that when the feeling and its frequency are left unaddressed the patient slips into a secondary feeling with a different brain pattern and frequency. Even though she may look like she connected and resolved the feeling there is a good chance that it is abreaction. It is simply the discharge of the energy of the feeling without connection.


 Let me make this clear because so many so-called primal therapists make this fundamental error. There is a time in the session when that feeling is very near conscious-awareness. Without professional help the feeling slides away and the patient, now floundering, manages to get into a different feeling, one that may belong to the therapist’s agenda, not the patient’s. That is because the therapist did not pick up on the entering feeling and then projects his own needs and feelings onto the patient. The patient then goes where the therapist decides, which has nothing to do with attacking the basic need and resolving it. Too often, the patient goes where the therapist tacitly is interested. The patient senses that and becomes a “good girl.’ The unconscious of the therapist implicitly directs the patient.


 The pain of lack of fulfillment is always an adjunct to a specific need. To address the wrong need is to forego proper connection and resolution; it is feeling the wrong pain at the wrong time. A depressed patient comes in feeling hopeless and helpless. The therapist may perceive latent anger and urges the patient to hit the wall. The release does offer some relief and they both may think there was resolution. But it was only temporary. The real feeling will return again and again only to be waylaid. Or the therapist may say, “Tell your mother!” But it may have nothing to do with mother, at least not the patient’s. What is coming up is the pain of the doctor; he needs to scream at his mother. Indeed, the patient’s core feeling may date back to a time before words. So expressing the feeling verbally is a false route. It is tricky business. A sound knowledge of the evolution of consciousness will help here.


 Doctors are used to being active during therapy sessions so it is difficult for them to see how little there is to do. I speak on average about 50 words a session. My patient feels and then the insights follow. I do not need the majesty of bestowing insights on patients. It is wonderful that they make their own discoveries. And what discoveries they are, up-surging feelings accompanied with their notes from the underground. Telling the doctor what the feelings mean.


 On the other hand, therapists have a lot to do when we sense abreaction entering in. At that point, the therapist must be vigilant and hyperactive to keep the patient on track. He must make sure not to reinforce the tributary feeling while steering the patient back to the main feeling. And how, you ask, does the therapist know the difference? By instinct and experience. The therapist has to sense that his patient has taken a detour and he has to know what the real feeling is. That skill you can only acquire by primal intuition. There is no law.

14 comments:

  1. Now my mother is dead!

    What is a feeling? The need! How does it look like? It is full of tears... holding my thumb with the other hand and "desperately" calling out for mom... it in my living room as loneliness is approaching! Then it just happens... the feeling of when mom leaves me as five year old in the hospital... alone without any idea when she'll be back. That is a feeling as long as it exists.
    Back in the room... and I know a lot more about feelings than I have ever done!

    Frank

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  2. Dear Art
    Maybe some day I will be able to relive all my pain and connect it corectly.

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  3. Now that is what I call getting to the core and spellig out how therapists have to be fully "tuned" to their client, knowing exactly the moment to speak or not. I have been observing for some years now seeing exactly as you describe.

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  4. Why we can become so vulnerable during the Primal therapeutic process!

    To imagine the child in us... when we as adults are embarrassed to meet someone we like... it's a matter of life and death! If it sounds ridiculous... or we become afraid... or causes any other reaction as we by any means trying to avoid... it's life of death that remind us!

    I do not think there are many psychiatrists who experienced the drama of standing in front of a train with assertiveness to jump... to be in longing and hopelessness for something absolutely necessary... something he/she experiencing will never happen. The intensity of death in itself! Death we senses the intensity of... death of being ashamed to meet someone for something he/she absolutely have to get... but in time long ago... can we imagine that?
    We need other than psychiatrists and psychologists!

    Frank

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  5. Dear Art,
    I understand how abreaction can be triggered by an unexperienced therapist. But what is the mechanism of abreaction in the case of self-primaling? When the patient is alone with noone to interfere is there a danger of abreaction? Or only a danger of not going deep enough into the feeling?
    Thanks
    Anna

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    1. Hello Anna!

      "But what is the mechanism of abreaction in the case of self-primaling"?Your neocortex!
      "When the patient is alone with noone to interfere is there a danger of abreaction"? Yes! Your questions tells of uncertainty where no one will suggest you to undergo primal therapy on your own! Head to Janovs center if you have the money ... it is betted where you get paid for every penny you spend.

      your Frank

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  6. I feel like the problem of abreaction would be most critical early in the therapy process when
    the patient is still learning.
    In an individual session I usually am clear on what I want to talk
    about and the feelings, as I have been doing this a long time. I don't find my therapist ever
    really redirecting, he mostly stays quiet and is just a really good listener, which isn't at all easy to do.
    In therapy groups, which I rarely get the chance to take of advantage of, it's more spontaneous and I have a harder time. It seems like anything could happen with other people reacting and
    the group amplifying the feelings.
    Phil

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    1. A reply to Phil by email:
      "Art

      I was unable to post this comment (a response to Phil) on your abreaction part 2 piece, so am sending to you direct:

      "Phil: I disagree; even long term primallers can slip into abreaction, especially when the pain awaiting them feels too much
      Also, I know that, as you say, many therapists are not directive or controlling, but that doesn´t mean they are proper primal therapists either. Gary"

      Also, I didn´t receive your latest (abreaction part 3) essay. Am I still subscribed?"

      Delete
    2. Gary, I checked and your subscription is active. art

      Delete
  7. Art: The following is an extract from an article titled "Natural Vs. Directive Primal therapy" by Harley Ristad, written in 1975, whilst a patient at the then Denver Primal Center. It illustrates perfectly what you are talking about. Gary

    "During my fourth month of therapy, a mistake was made whereby I was subjected to some directive therapy which brought up some pain out of its natural sequence. I was a willing and cooperative participant who believed that good therapy had been done. It was two months later when it suddenly became clear to me why my therapy had stagnated. I believe this mistake set my therapy back more than a month. Because of this mistake, I have learned how very good natural primal therapy has been for me.

    It happened on a Friday; I had been deep into my feelings for six hours, and came out of a two hour primal in, the middle of post group. (Patients are in separate rooms during group, and meet in one large room for post group.) It was then that another patient, who was a stranger to me, dumped a lot of anger on me. I was very together, felt his charges were nonsense, and chose not to dignify his diatribe with a defensive reply. Instead, I tried to share with the group that I had just primalled being left all night alone in a hospital when I was about one year old with my arms strapped to my sides like a slab of beef and insects biting my face. When I was in most need of support for my feelings, the therapists joined the goup with their need to see gladiators in action. They urged me into a different response, and I replied with anger.

    At my next session, the following Monday, my therapist chose to talk about the Friday anger dump. I was told that, as an adult, I can see that the anger is crazy, but when I was a little boy I couldn't. In post group the same patient dumped his anger on me again. This time, I followed my therapist's suggestion and went with the feeling of being small and not being able to figure out the craziness. I went down on the floor, and went real deep, My therapist greatly intensified the pain when she put her hand on my shoulder.

    Being pushed to where I wasn't ready to go was so unnecessary. The anger dumps were locked in my memory. At some later session, when my body was ready, I could have gone into feelings about them. Natural primal therapy assumes that there is a natural sequence for a patient to feel his buried pain which is unique for each patient and can never be known by the therapist"

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  8. You're damned right: what blocks the patient's brainstem from freeing its accounted terror is the therapist's own fear to witness his own being triggered by that. Oh my God. "Tell (shout at) your mother!": certainly a detouring neglect (subsequent laryngeal irritation avoidable?) Do you mean no patient needs to be told, even suggested, to tell her mother -let alone on a face to face basis?. I'd say That precise vomiting happens naturally when it comes to freeing the cognitive Brain, and that belongs to the realm of first line discharges from daily uploads, doesn't it?. I was once told there comes one time (and only one) to tell your mother and father a few home truths. Do you feel that is pointless and helps relief in no way?.
    Accurate as ever. Thank You. Lars

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    Replies
    1. Lars: Not pointless but when it is right, decided always by the patient. We never know what feeling needs expressing until it arrives. No therapist is smarter than the patient. That is what mock therapists do in their arrogance and innocence. Art

      Delete

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Editor